Charles K Vojta, O.D.
Individual provider Active NPI Optometrist · Mancos, CO
NPI 1114213758 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1114213758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2859 (CO)
- Practice address
- 12502 Road 38
Mancos, CO 81328-7930 - Phone
- (970) 769-2458
- NPI assigned
- Jun 22, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2859 | CO | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Better Sight LLC | Optometrist | Current | Accepting new patients |
| Charles Vojta OD LTD | Optometrist | Past |
Accepting new patients |
Locations
7821 King St
Unit 3
Anchorage, AK 99518
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 355 | AK | |
| Optometrist | 152W00000X | 2859 | CO | Yes |
Addresses
Primary practice location
12502 Road 38
Mancos, CO 81328-7930
Mailing address
12502 Road 38
Mancos, CO 81328-7930
Phone (970) 769-2458
Other practice location 1
2260 Tasha Dr
Anchorage, AK 99502-5467
Phone (970) 769-2458
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36475556 | Medicaid | CO | |
| 1618291 | Medicaid | AK |
Other providers in Mancos, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.