NPIMap

Organization Active NPI

Nationwide Optometry P.C.

Doing business as Nationwide Vision

  • Optometrist
  • Prescott Valley, AZ
National Provider Identifier
1174930325
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NATIONWIDE OPTOMETRY P.C.
Doing business as
Nationwide Vision
Practice address
3264 N Glassford Hill Rd Ste E
Prescott Valley, AZ 86314-1353
Phone
(928) 717-5318
Fax
(928) 717-5323
NPI assigned
Jul 21, 2014
Last updated
Nov 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Jarrod Cross, ODNPI 1477881522
Title
President
Phone
(509) 201-0051

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

3264 N Glassford Hill Rd Ste E
Prescott Valley, AZ 86314-1353

Mailing address

955 W Southern Ave Ste 101
Mesa, AZ 85210-4903
Phone (480) 961-1865

Other names 1

  • Nationwide Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241206000991 AZ DME Supplier - Physician - Optometrist 6901033075 Practice locations: Prescott Valley, AZ

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
Nationwide Vision3264 N Glassford Hill Rd, Prescott Valley, AZ 86314-1353(928) 717-5318 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Oct 1, 2013

National Provider Directory

National Provider Directory
Tax ID family
Nationwide Optometry PC19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3264 N Glassford Hill Rd
Ste E
Prescott Valley, AZ 86314
Phone (928) 717-5318

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1174930325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W SOUTHERN AVE STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104903",
            "telephone_number": "480-961-1865",
            "fax_number": "480-893-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N GLASSFORD HILL RD STE E",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141353",
            "telephone_number": "928-717-5318",
            "fax_number": "928-717-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONWIDE OPTOMETRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "JARROD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-201-0051",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nationwide Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.