NPIMap

Organization Active NPI

National Vision, Inc.

  • Optometrist
  • Roswell, NM
National Provider Identifier
1063459147
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NATIONAL VISION, INC.
Practice address
4500 N Main St
Roswell, NM 88201-0305
Phone
(505) 622-7262
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Leahann Vaughn
Title
Managed Care Sales Coordinator
Phone
(470) 448-2782

Specialties & licenses 1

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

Addresses

Primary practice location

4500 N Main St
Roswell, NM 88201-0305

Mailing address

2435 Commerce Ave
BLDG 2200
Duluth, GA 30096-4980
Phone (800) 571-5202

Other identifiers 1

IdentifierTypeStateIssuer
H7001MedicaidNM

Other names 1

  • Vision Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wal Mart Vision Ctr 2141,614 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

4500 N Main St
Roswell, NM 88201
Phone (575) 622-3812

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1063459147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 COMMERCE AVE",
            "address_2": "BLDG 2200",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964980",
            "telephone_number": "800-571-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882010305",
            "telephone_number": "505-622-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL VISION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LEAHANN",
        "authorized_official_title_or_position": "MANAGED CARE SALES COORDINATOR",
        "authorized_official_telephone_number": "470-448-2782"
    },
    "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": "H7001",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.