NPIMap

Organization Active NPI

Bright Eyes Vision Clinic PC a Colorado Professional Corporation

  • Optometrist
  • Denver, CO
National Provider Identifier
1033710066
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BRIGHT EYES VISION CLINIC PC A COLORADO PROFESSIONAL CORPORATION
Practice address
2250 S Monaco Pkwy
Denver, CO 80222-5814
Phone
(303) 476-6233
NPI assigned
Nov 5, 2020
Organization subpart
Yes
Parent organization
BRIGHT EYES VISION CLINIC PC A COLORADO PROFESSIONAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Authorized official

Name
Jennifer Killen
Title
Credentialing Specialist
Phone
(719) 276-0344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2250 S Monaco Pkwy
Denver, CO 80222-5814

Mailing address

326 Dozier Ave
Canon City, CO 81212-2706
Phone (719) 276-0344

Other identifiers 1

IdentifierTypeStateIssuer
9000131791MedicaidCO

Other names 1

  • Bright Eyes Family Vision Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bright Eyes Vision Clinic PC a Colorado Professional Corporation6 organizations share this tax ID, including this one
Part of
Bright Eyes Vision Clinic PC a Colorado Professional Corporation

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2250 S Monaco Pkwy
Denver, CO 80222
Phone (303) 476-6233

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1033710066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 DOZIER AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122706",
            "telephone_number": "719-276-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MONACO PKWY",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802225814",
            "telephone_number": "303-476-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT EYES VISION CLINIC PC A COLORADO PROFESSIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHT EYES VISION CLINIC PC A COLORADO PROFESSIONAL CORPORATION",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "KILLEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "719-276-0344"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000131791",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Eyes Family Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.