Wagner Optometry PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

18-11667-0000 Issued in CO

Legal business name

WAGNER OPTOMETRY PC

Doing business as

Family Vision Center

Practice address

10071 Wadsworth Pkwy
Ste. 200
Westminster, CO 80021-3804

Phone

(303) 427-2020

Fax

(303) 427-6197

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert H. Wagner, O.D.NPI 1477515385

Title

Owner

Phone

(303) 427-2020

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• FAMILY VISION CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Hampton Wagner, O.D.

  • Optometrist
  • Westminster, CO
  • NPI 1477515385
  Medicare reassignment Care Compare group NPD Authorized official
• Loree Ebbinghaus Wagner, O.D.

  • Optometrist
  • Westminster, CO
  • NPI 1790748903
  Medicare reassignment Care Compare group NPD
• Kim Ngoc Tran, OD

  • Optometrist
  • Aurora, CO
  • NPI 1033787064
  Medicare reassignment NPD
• Joanne C. Takara, O.D.

  • Optometrist
  • Pearl City, HI
  • NPI 1598775314
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1063561587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10071 WADSWORTH PKWY",
            "address_2": "STE. 200",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800213804",
            "telephone_number": "303-427-2020",
            "fax_number": "303-427-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10071 WADSWORTH PKWY",
            "address_2": "STE. 200",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800213804",
            "telephone_number": "303-427-2020",
            "fax_number": "303-427-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-427-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "18-11667-0000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790748903",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1477515385",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY VISION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy Vollmer, DO
• Jonna Von Schulz, PH.D
• Karen S Vonderhaar, MS, PT, OCS
• Courtney Sarah Voorus, PA-C
• Annika Vorsteveld, RBT
• James Colin Wagner, D.C.
• Loree Ebbinghaus Wagner, O.D.
• Robert Hampton Wagner, O.D.
• Mackenzie Mae Wahl, MD
• Levi Wait, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.