NPIMap

Organization Active NPI

Blair Vision Care, LLC

  • Optometrist
  • Canon City, CO
National Provider Identifier
1134436728
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2800 Issued in CO
Legal business name
BLAIR VISION CARE, LLC
Practice address
700 Main St
Canon City, CO 81212
Phone
(719) 431-6434
Fax
(719) 431-6435
NPI assigned
Sep 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Authorized official

Name
Dr. Nicholas Blair, O.D.NPI 1871807321
Title
Owner
Phone
(719) 362-3483

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 2800 CO Primary

Addresses

Primary practice location

700 Main St
Canon City, CO 81212

Mailing address

700 Main St
Canon City, CO 81212-3739
Phone (719) 431-6434

Other practice location 1

3105 E US Highway 50
Canon City, CO 81212-2797
Phone (719) 362-3483

Other practice location 2

3958 N Academy Blvd Ste 108-109
Colorado Springs, CO 80917-5919
Phone (719) 999-8404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100922000472 CO Part B Supplier - Clinic/Group Practice 8123144680 Receives reassigned benefits from 2 practitioners
Practice locations: Canon City, CO

National Provider Directory

National Provider Directory
Tax ID family
Blair Vision Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3958 N Academy Blvd
Ste 108109
Colorado Springs, CO 80917
Phone (719) 999-8404

Practitioners & affiliated clinicians

Practitioners 2

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": "1283472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1134436728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MAIN ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123739",
            "telephone_number": "719-431-6434",
            "fax_number": "719-431-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MAIN ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "81212",
            "telephone_number": "719-431-6434",
            "fax_number": "719-431-6435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3105 E US Highway 50",
            "address_purpose": "LOCATION",
            "city": "Canon City",
            "state": "CO",
            "postal_code": "812122797",
            "country_code": "US",
            "telephone_number": "719-362-3483",
            "fax_number": "719-269-8458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3958 N Academy Blvd Ste 108-109",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809175919",
            "country_code": "US",
            "telephone_number": "719-999-8404",
            "fax_number": "719-999-8405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLAIR VISION CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-03",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-362-3483",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.