NPIMap

Organization Active NPI

First Impressions Optometric Associates, LLC

  • Eyewear Supplier
  • Bloomington, IN
National Provider Identifier
1144980830
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
FIRST IMPRESSIONS OPTOMETRIC ASSOCIATES, LLC
Practice address
2894 E 3Rd St Ste 155
Bloomington, IN 47401-5498
Phone
(812) 336-2702
Fax
(812) 336-2705
NPI assigned
Dec 22, 2021
Last updated
Sep 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Authorized official

Name
Aja Bowling, ODNPI 1255667481
Title
Owner
Phone
(270) 750-8384

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
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

2894 E 3Rd St Ste 155
Bloomington, IN 47401-5498

Mailing address

175 E Houston St
San Antonio, TX 78205-2255
Phone (726) 444-4078

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220331002567 IN DME Supplier - Physician - Optometrist 6800281825 Practice locations: Bloomington, IN

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
First Impressions Optometric Associ2894 E 3Rd St, Bloomington, IN 47401-5498(812) 336-2702 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Feb 6, 2022

National Provider Directory

National Provider Directory
Tax ID family
First Impressions Assoc LLC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1144980830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HOUSTON ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052255",
            "telephone_number": "726-444-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2894 E 3RD ST STE 155",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015498",
            "telephone_number": "812-336-2702",
            "fax_number": "812-336-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST IMPRESSIONS OPTOMETRIC ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-22",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "AJA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-750-8384",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.