NPIMap

Organization Active NPI

Professional Visioncare of Colorado LLC

  • Optometrist
  • Grand Junction, CO
National Provider Identifier
1073847802
Registry record updated Sep 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2739 Issued in CO
Legal business name
PROFESSIONAL VISIONCARE OF COLORADO LLC
Practice address
1040 Independent Ave
Grand Junction, CO 81505-7133
Phone
(970) 254-2880
NPI assigned
Sep 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2009

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

Authorized official

Name
Benjamin Collins, O.D.
Title
President
Phone
(801) 709-8623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2739 CO Primary

Addresses

Primary practice location

1040 Independent Ave
Grand Junction, CO 81505-7133

Mailing address

772 Jasper Dr
Fruita, CO 81521-8312

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253836800000",
    "number": "1073847802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "772 JASPER DR",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815218312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 INDEPENDENT AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815057133",
            "telephone_number": "970-254-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL VISIONCARE OF COLORADO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-25",
        "last_updated": "2009-09-25",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-709-8623",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; 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.