Organization Active NPI

Vision Source, Inc.

  • Optometrist
  • Birmingham, AL
National Provider Identifier
1063587590
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
07005076 Issued in AL
Legal business name
VISION SOURCE, INC.
Doing business as
GRAYSON VALLEY FAMILY EYE CARE
Practice address
5590 Chalkville Rd Ste B
Birmingham, AL 35235-8637
Phone
(205) 520-9002
Fax
(205) 520-9064
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Authorized official

Name
Dr. Gary C Few, O.D.NPI 1689653875
Title
President
Phone
(205) 520-9002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 07005076 AL Primary

Addresses

Primary practice location

5590 Chalkville Rd Ste B
Birmingham, AL 35235-8637

Mailing address

5590 Chalkville Rd
Suite B
Birmingham, AL 35235-8636
Phone (205) 520-9002

Other identifiers 2

IdentifierTypeStateIssuer
051523183MedicaidAL
051523259MedicaidAL

Other names 1

  • GRAYSON VALLEY FAMILY EYE CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040806000096 AL Part B Supplier - Clinic/Group Practice 4981676483 Receives reassigned benefits from 3 practitioners
Practice locations: Trussville, AL

National Provider Directory

National Provider Directory

Locations

5590 Chalkville Rd
Ste B
Birmingham, AL 35235
Phone (205) 520-9002

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1063587590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 CHALKVILLE RD",
            "address_2": "SUITE B",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352358636",
            "telephone_number": "205-520-9002",
            "fax_number": "205-520-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5590 CHALKVILLE RD STE B",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352358637",
            "telephone_number": "205-520-9002",
            "fax_number": "205-520-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SOURCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "FEW",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-520-9002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "07005076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051523183",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051523259",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRAYSON VALLEY FAMILY EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.