NPIMap

Organization Active NPI

Vermont Optical Corp

  • Eyewear Supplier
  • Rutland, VT
National Provider Identifier
1053511147
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
028-0000350 Issued in VT
Legal business name
VERMONT OPTICAL CORP
Practice address
69 Allen St
Suite 15
Rutland, VT 05701-4564
Phone
(802) 774-5124
Fax
(802) 774-5129
NPI assigned
Jul 18, 2007
Last updated
Jan 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Authorized official

Name
Mr. Gregory Chandler Birajiclian, OPTICIAN
Title
President
Phone
(802) 774-5124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 028-0000350 VT Primary

Addresses

Primary practice location

69 Allen St
Suite 15
Rutland, VT 05701-4564

Mailing address

69 Allen St
Suite 15
Rutland, VT 05701-4564
Phone (802) 774-5124

National Provider Directory

National Provider Directory

Locations

69 Allen St
Ste 15
Rutland, VT 05701
Phone (802) 775-0038

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357084800000",
    "number": "1053511147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 ALLEN ST",
            "address_2": "SUITE 15",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014564",
            "telephone_number": "802-774-5124",
            "fax_number": "802-774-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 ALLEN ST",
            "address_2": "SUITE 15",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014564",
            "telephone_number": "802-774-5124",
            "fax_number": "802-774-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMONT OPTICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2013-01-02",
        "status": "A",
        "authorized_official_last_name": "BIRAJICLIAN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "CHANDLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-774-5124",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "VT",
            "license": "028-0000350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.