Active NPI
Hero Vision of Longmont, LLC
- Optometrist
- Longmont, CO
National Provider Identifier
1194021386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- HERO VISION OF LONGMONT, LLC
- Practice address
- 1739 N Main St
Longmont, CO 80501-2035 - Phone
- (303) 834-6400
- Fax
- (303) 834-6414
- NPI assigned
- Feb 4, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shaun Urbanozo
- Title
- Credentialing Manager
- Phone
- (719) 323-2362
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
1739 N Main St
Longmont, CO 80501-2035
Mailing address
2221 E Bijou St
Ste 100
Colorado Springs, CO 80909
Phone (303) 834-6400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78105081 | Medicaid | CO |
Other names 1
- Adventure Dental Vision and Orthondontics
National Provider Directory
National Provider Directory- Tax ID family
- Hero Vision of Longmont LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Longmont, CO
- NPI 1578167037
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Optometrist
- Longmont, CO
- NPI 1578167037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296777600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1606089600000",
"number": "1194021386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2221 E BIJOU ST",
"address_2": "STE 100",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80909",
"telephone_number": "303-834-6400",
"fax_number": "303-834-6414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1739 N MAIN ST",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805012035",
"telephone_number": "303-834-6400",
"fax_number": "303-834-6414"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HERO VISION OF LONGMONT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-02-04",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A",
"authorized_official_last_name": "URBANOZO",
"authorized_official_first_name": "SHAUN",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "719-323-2362"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78105081",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Adventure Dental Vision and Orthondontics",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.