Havrilla Vision Professional LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0002925 Issued in CO

Legal business name

HAVRILLA VISION PROFESSIONAL LLC

Practice address

551 S Hover St
Longmont, CO 80501-7920

Phone

(970) 629-1325

NPI assigned

Sep 20, 2012

Organization subpart

No

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

Authorized official

Name

Jennifer Havrilla, O.D.

Title

Owner

Phone

(970) 629-1325

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1043561863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 E 5TH ST",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805375744",
            "telephone_number": "970-629-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 S HOVER ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017920",
            "telephone_number": "970-629-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVRILLA VISION PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "HAVRILLA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-629-1325",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0002925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meryn Harwood, PA-C
• Stephen Walter Haskew, MD
• Jason Hatch, MD
• April Christina Haukoos, A.R.N.P.
• Daniel Hauser
• Constance Hayden, MS, PTA
• Robert Haydock
• Sydney Davidson Haynes, PT, DPT
• Headache & TMJ Center
• Healingquest LLP

• Optometrist in Longmont, CO
• Providers in Longmont, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.