NPIMap

Organization Active NPI

National Vision, Inc.

  • Optometrist
  • Albuquerque, NM
National Provider Identifier
1164469045
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NATIONAL VISION, INC.
Practice address
301 San Mateo Blvd SE
Albuquerque, NM 87108-2919
Phone
(505) 255-9955
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Leahann Rene Vaughn
Title
Director
Phone
(470) 448-2782

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

301 San Mateo Blvd SE
Albuquerque, NM 87108-2919

Mailing address

PO Box 951336
Dallas, TX 75395-1336

Other identifiers 1

IdentifierTypeStateIssuer
E9115MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Wal Mart Vision Ctr 2141,614 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1164469045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 951336",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753951336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SAN MATEO BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082919",
            "telephone_number": "505-255-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL VISION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LEAHANN",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "470-448-2782"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E9115",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.