Vance Thompson Vision Mt Prof LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

VANCE THOMPSON VISION MT PROF LLC

Practice address

1925 N 22ND Ave
Bozeman, MT 59718-7020

Phone

(877) 522-3937

NPI assigned

Jun 6, 2017

Last updated

Jan 7, 2021By 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

Matt Jensen

Title

Ceo

Phone

(605) 361-3937

Specialties & licenses 3

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.

• Cullen Dean Ryburn, M.D.

  • Ophthalmology Physician
  • Loveland, CO
  • NPI 1679950976
  NPD (past)

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1144759945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571083162",
            "telephone_number": "605-361-3937",
            "fax_number": "605-371-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 N 22ND AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187020",
            "telephone_number": "877-522-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCE THOMPSON VISION MT PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-361-3937"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MT",
            "license": "MED-PHYS-LIC-57511",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Marie Van Antwerp, MS, LCPC
• Landon Van Dell, MD
• Kenneth C Van Kirk, DDS
• Ali Van Raaphorst
• Caitlin Van Sloun
• Vance Thompson Vision Surgery Center Bozeman, LLC
• Alexander Vance, MD
• Amy Vance, FNP-C
• Melissa Saab Vance, MD
• Maekayla Vandenburg

• Ophthalmology Physician in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Ophthalmology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.