Western States Optical, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

WESTERN STATES OPTICAL, INC.

Practice address

1268 Interquest Pkwy Ste 120
Colorado Springs, CO 80921-4209

Phone

(719) 639-7014

NPI assigned

Sep 15, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert Lee Walters

Title

Licensed Operator

Phone

(540) 424-6921

Specialties & licenses 1

Addresses

Other names 1

• Pearle Vision Eyecare of Colorado Springs Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1013522010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 INTERQUEST PKWY STE 120",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809214209",
            "telephone_number": "540-424-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 INTERQUEST PKWY STE 120",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809214209",
            "telephone_number": "719-639-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN STATES OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2024-07-03",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "LICENSED OPERATOR",
        "authorized_official_telephone_number": "540-424-6921",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision Eyecare of Colorado Springs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pearle Vision Eyecare of Colorado Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Eric Westcot, D.O.
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• Carley Danielle Westerson, LPC
• Justine Westervelt
• Alisha Michelle Westfall
• Christopher Ryan Westfall
• Jennifer Westfall, BA

• Eyewear Supplier in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Eyewear Supplier in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.