NPIMap

Organization Active NPI

Nationwide Optometry P.C.

  • Corneal and Contact Management Optometrist
  • Davis Monthan Afb, AZ
National Provider Identifier
1053765370
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
Legal business name
NATIONWIDE OPTOMETRY P.C.
Practice address
5405 E Granite St
BLDG. 2527
Davis Monthan Afb, AZ 85707-3004
Phone
(520) 745-5669
NPI assigned
Apr 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Joseph Pravoot Gira, MD
Title
Chief Medical Officer
Phone
(314) 909-0633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WC0802X Primary

Addresses

Primary practice location

5405 E Granite St
BLDG. 2527
Davis Monthan Afb, AZ 85707-3004

Mailing address

955 W Southern Ave Ste 101
Mesa, AZ 85210-4903
Phone (480) 961-1865

National Provider Directory

National Provider Directory
Tax ID family
Nationwide Vision Cente18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1053765370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W SOUTHERN AVE STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104903",
            "telephone_number": "480-961-1865",
            "fax_number": "480-893-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 E GRANITE ST",
            "address_2": "BLDG. 2527",
            "city": "DAVIS MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857073004",
            "telephone_number": "520-745-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONWIDE OPTOMETRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-22",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "GIRA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "PRAVOOT",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "314-909-0633",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis Monthan Afb, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.