Hero Vision of Utica, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

HERO VISION OF UTICA, LLC

Practice address

602 S Utica Ave
Tulsa, OK 74104-2641

Phone

(918) 585-3744

Fax

(719) 955-3470

NPI assigned

Mar 25, 2019

Organization subpart

No

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

Authorized official

Name

Charlotte Souder

Title

Credentialing Manager

Phone

(719) 576-1850

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1184184129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809098009",
            "telephone_number": "719-570-1850",
            "fax_number": "719-955-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741042641",
            "telephone_number": "918-585-3744",
            "fax_number": "719-955-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERO VISION OF UTICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "SOUDER",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-576-1850"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.