Provider Demographics
NPI:1093797912
Name:SPEARS, IVY HOPP (OD)
Entity Type:Individual
Prefix:DR
First Name:IVY
Middle Name:HOPP
Last Name:SPEARS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 BEY LEA RD
Mailing Address - Street 2:BEY LEA COMMONS SUITE C 104
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2900
Mailing Address - Country:US
Mailing Address - Phone:732-341-1070
Mailing Address - Fax:732-341-1652
Practice Address - Street 1:40 BEY LEA RD
Practice Address - Street 2:BEY LEA COMMONS SUITE C 104
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2900
Practice Address - Country:US
Practice Address - Phone:732-341-1070
Practice Address - Fax:732-341-1652
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00435400152W00000X, 152WC0802X, 152WP0200X, 152WS0006X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0075755000OtherAMERIHEALTH IND PROV ID
NJ201330164OtherQUALCARE GROUP ID NUMBER
NJ3275906Medicaid
NJ50596OtherDAVIS VISION ID NUMBER
NJ60016235OtherHORIZON NJ HEALTH
NJ310954OtherNATIONAL VISION ADMIN ID
NJ0055395Medicaid
NJ2K7427OtherHEALTHNET IND ID NUMBER
NJ01000500200OtherAMERICHOICE
NJ3628546OtherAETNA (HMO)
NJP466316OtherOXFORD IND ID NUMBER
NJ30903OtherGROUP VISION ASSOC ID NUM
NJG3410217OtherOXFORD GROUP ID NUMBER
NJ201330164OtherHORIZON BC/BS ID NUMBER
NJ2341813000OtherAMERIHEALTH GROUP ID NUMB
NJ3242884OtherCIGNA IND ID NUMBER
NJ4502254OtherAETNA (NON-HMO)
NJ01000500200OtherAMERICHOICE
NJ3275906Medicaid
NJ088581Medicare ID - Type UnspecifiedGROUP ID NUMBER