NPIMap

Organization Active NPI

Precision Vision Corporation

  • Optometrist
  • Pikesville, MD
National Provider Identifier
1073911756
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1769 Issued in MD
Legal business name
PRECISION VISION CORPORATION
Doing business as
Precision Vision
Practice address
1500 Reisterstown Rd
Suite 208
Pikesville, MD 21208-4339
Phone
(410) 653-2400
Fax
(410) 653-2402
NPI assigned
Dec 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Authorized official

Name
Dr. Selvin Gnanakkan, OD
Title
Optometrist
Phone
(602) 770-9300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1769 MD Primary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1127 AZ
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X 1769 MD

Addresses

Primary practice location

1500 Reisterstown Rd
Suite 208
Pikesville, MD 21208-4339

Mailing address

1500 Reisterstown Rd
Suite 208
Pikesville, MD 21208-4339
Phone (410) 653-2400

Other identifiers 1

IdentifierTypeStateIssuer
031847700MedicaidMD

Other names 1

  • Precision Vision Doing business as

National Provider Directory

National Provider Directory

Locations

1500 Reisterstown Rd
Ste 208
Pikesville, MD 21208
Phone (410) 205-7864

NPI Registry JSON

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418342400000",
    "number": "1073911756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 REISTERSTOWN RD",
            "address_2": "SUITE 208",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212084339",
            "telephone_number": "410-653-2400",
            "fax_number": "410-653-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 REISTERSTOWN RD",
            "address_2": "SUITE 208",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212084339",
            "telephone_number": "410-653-2400",
            "fax_number": "410-653-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION VISION CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-12",
        "last_updated": "2014-12-12",
        "status": "A",
        "authorized_official_last_name": "GNANAKKAN",
        "authorized_official_first_name": "SELVIN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "602-770-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "1769",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1127",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MD",
            "license": "1769",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031847700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Precision Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; 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.