NPIMap

Organization Active NPI

Kokopelli Eye Care Optical Dept

  • Optician
  • Prescott Valley, AZ
National Provider Identifier
1043477847
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
AZ26357 Issued in AZ
Legal business name
KOKOPELLI EYE CARE OPTICAL DEPT
Practice address
2820 N Glassford Hill Rd
Suite 101
Prescott Valley, AZ 86314-1242
Phone
(928) 775-5606
Fax
(928) 772-4999
NPI assigned
May 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Barbie Elias
Title
Administrator
Phone
(928) 775-5606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X AZ26357 AZ Primary

Addresses

Primary practice location

2820 N Glassford Hill Rd
Suite 101
Prescott Valley, AZ 86314-1242

Mailing address

2820 N Glassford Hill Rd
Suite 101
Prescott Valley, AZ 86314-1242
Phone (928) 775-5606

National Provider Directory

National Provider Directory

Locations

2820 N Glassford Hill Rd
Ste 101
Prescott Vly, AZ 86314
Phone (928) 771-9000

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1043477847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "address_2": "SUITE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141242",
            "telephone_number": "928-775-5606",
            "fax_number": "928-772-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "address_2": "SUITE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141242",
            "telephone_number": "928-775-5606",
            "fax_number": "928-772-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKOPELLI EYE CARE OPTICAL DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "ELIAS",
        "authorized_official_first_name": "BARBIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "928-775-5606"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "AZ",
            "license": "AZ26357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.