Vision Source Longmont, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

857 Issued in CO

Legal business name

VISION SOURCE LONGMONT, PC

Practice address

2130 Mountain View Avenue
Suite 207
Longmont, CO 80501

Phone

(303) 772-2755

NPI assigned

Dec 21, 2006

Last updated

Mar 6, 2013By 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

Dr. Jason L. Kaminski, O.D.NPI 1790788156

Title

Owner

Phone

(303) 772-2755

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jason L Kaminski, O.D., F.A.A.O.

  • Optometrist
  • Longmont, CO
  • NPI 1790788156
  Authorized official Same address or phone

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1104980234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 MOUNTAIN VIEW AVENUE",
            "address_2": "SUITE 207",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MOUNTAIN VIEW AVENUE",
            "address_2": "SUITE 207",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "303-772-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SOURCE LONGMONT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "KAMINSKI",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-772-2755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Longmont, CO
• Providers in Longmont, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.