NPIMap

Organization Active NPI

Vision Loft, O.D., P.a.

  • Optometrist
  • Concord, NC
National Provider Identifier
1124281639
Registry record updated Feb 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC 1929 Issued in NC
Legal business name
VISION LOFT, O.D., P.A.
Practice address
8415 Pit Stop Court
Suite 100
Concord, NC 28027-8186
Phone
(704) 785-8070
Fax
(888) 809-1433
NPI assigned
Jul 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2009

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

Authorized official

Name
Dr. Bonnie P Chen, O.D.NPI 1861681678
Title
President
Phone
(704) 979-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X NC 1929 NC Primary

Addresses

Primary practice location

8415 Pit Stop Court
Suite 100
Concord, NC 28027-8186

Mailing address

8415 Pit Stop Court
Suite 100
Concord, NC 28027-8186
Phone (704) 979-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090406000635 NC Part B Supplier - Clinic/Group Practice 4082761168 Receives reassigned benefits from 4 practitioners
Practice locations: Concord, NC

National Provider Directory

National Provider Directory

Locations

8415 Pit Stop Ct NW
Concord, NC 28027

8415 Pit Stop Ct NW
Ste 100
Concord, NC 28027
Phone (704) 785-8070

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235692800000",
    "number": "1124281639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 PIT STOP COURT",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280278186",
            "telephone_number": "704-979-3937",
            "fax_number": "888-809-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 PIT STOP COURT",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280278186",
            "telephone_number": "704-785-8070",
            "fax_number": "888-809-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION LOFT, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2009-02-27",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-979-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC 1929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; 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.