Teton Valley Vision PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100009 Issued in ID

Legal business name

TETON VALLEY VISION PC

Practice address

7389 S Hwy 33
Ste B
Victor, ID 83455

Phone

(208) 787-3937

NPI assigned

Oct 31, 2014

Last updated

Oct 31, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas Simmons, O.D.NPI 1144313305

Title

Owner

Phone

20878739397

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Simmons, O.D.

  • Optometrist
  • Victor, ID
  • NPI 1144313305
  Medicare reassignment NPD Authorized official
• Eliza Marguerite Whatley Martin, O.D.

  • Optometrist
  • Driggs, ID
  • NPI 1376299040
  Medicare reassignment NPD

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1073918173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7389 S HWY 33",
            "address_2": "STE B",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "83455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7389 S HWY 33",
            "address_2": "STE B",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "83455",
            "telephone_number": "208-787-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON VALLEY VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "20878739397",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tristan Taylor, D.D.S.
• Teton Dietetics LLC
• Teton Headwaters, Inc Dba Aspen Wellness
• Teton Valley Health Care, Inc (Victor Clinic)
• Teton Valley Hosital & Surgicenter (Victor Medical Clinic)
• Thomas L Simmons (Teton Valley Vision Clinic)
• Valley in Motion Physical Therapy, LLC
• W.E.S.T. Physical Therapy, PLLC
• Babbs L Weissman, PPC
• Emily Williams, OTR

• Optometrist in Victor, ID
• Providers in Victor, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.