Individual provider Active NPI

James G Liston, OD

  • Optometrist
  • Tucson, AZ
National Provider Identifier
1023129699
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AZ0783 Issued in AZ
Practice address
7123 E Tanque Verde Rd
Tucson, AZ 85715-3431
Phone
(520) 296-1726
Fax
(520) 296-4418
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AZ0783 AZ Primary

Addresses

Primary practice location

7123 E Tanque Verde Rd
Tucson, AZ 85715-3431

Mailing address

440 N Alvernon Way
Tucson, AZ 85711-1958
Phone (520) 327-6215

Other identifiers 1

IdentifierTypeStateIssuer
396029MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025000150 AZ Practitioner - Optometry 4183641624 Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ0783AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Eye Care, PLC Optometrist Past Accepting new patients
Sunburst Optical Optometrist PastSince Jan 1, 1990 Accepting new patients
Family Vision Source, LLC Optometrist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023129699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N ALVERNON WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111958",
            "telephone_number": "520-327-6215",
            "fax_number": "520-327-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7123 E TANQUE VERDE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153431",
            "telephone_number": "520-296-1726",
            "fax_number": "520-296-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTON",
        "first_name": "JAMES",
        "middle_name": "G",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "AZ0783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "396029",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.