NPIMap

Organization Active NPI

Summerlin Vision Center Inc

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1063608313
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
448 Issued in NV
Legal business name
SUMMERLIN VISION CENTER INC
Practice address
7664 W Lake Mead Blvd Ste 107
Las Vegas, NV 89128-6645
Phone
(702) 254-6222
Fax
(702) 341-9541
NPI assigned
Sep 20, 2007
Reactivated
Feb 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Dr. Christopher Chiodo, ODNPI 1750435921
Title
Owner
Phone
(702) 254-6222

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 294 NV
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 448 NV Primary

Addresses

Primary practice location

7664 W Lake Mead Blvd Ste 107
Las Vegas, NV 89128-6645

Mailing address

7664 W Lake Mead Blvd
# 107
Las Vegas, NV 89128-6645
Phone (702) 254-6222

Other identifiers 1

IdentifierTypeStateIssuer
37228OtherNVMEDICARE ID- TYPE UNSPECIFIED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040427000040 NV Part B Supplier - Clinic/Group Practice 0244227908 Receives reassigned benefits from 4 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

7664 W Lake Mead Blvd
Ste 107
Las Vegas, NV 89128
Phone (702) 254-6222

Practitioners & affiliated clinicians

Practitioners 10

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": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1063608313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7664 W LAKE MEAD BLVD",
            "address_2": "# 107",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286645",
            "telephone_number": "702-254-6222",
            "fax_number": "702-341-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7664 W LAKE MEAD BLVD STE 107",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286645",
            "telephone_number": "702-254-6222",
            "fax_number": "702-341-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERLIN VISION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "deactivation_date": "2023-02-01",
        "reactivation_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "CHIODO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-254-6222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "294",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID- TYPE UNSPECIFIED",
            "identifier": "37228",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.