NPIMap

Organization Active NPI

Gallatin Valley Vision, LLC

  • Optometrist
  • Bozeman, MT
National Provider Identifier
1205280989
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2236 Issued in MT
Legal business name
GALLATIN VALLEY VISION, LLC
Practice address
2825 W Main St Ste 1E
Bozeman, MT 59718-3927
Phone
(406) 587-7050
Fax
(406) 587-0525
NPI assigned
Apr 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Authorized official

Name
Dr. Jessica Lemons, ODNPI 1497061659
Title
Optometrist
Phone
(406) 581-5181

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2236 MT Primary

Addresses

Primary practice location

2825 W Main St Ste 1E
Bozeman, MT 59718-3927

Mailing address

2825 W Main St Ste 1E
Bozeman, MT 59718-3927
Phone (406) 587-7050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160505000621 MT Part B Supplier - Clinic/Group Practice 8426357930 Receives reassigned benefits from 2 practitioners
Practice locations: Bozeman, MT; Three Forks, MT

National Provider Directory

National Provider Directory
Tax ID family
Gallatin Valley Vision LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2825 W Main St
Ste 1E
Bozeman, MT 59718
Phone (406) 587-7050

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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461024000000",
    "number": "1205280989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 W MAIN ST STE 1E",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183927",
            "telephone_number": "406-587-7050",
            "fax_number": "406-587-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 W MAIN ST STE 1E",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183927",
            "telephone_number": "406-587-7050",
            "fax_number": "406-587-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLATIN VALLEY VISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A",
        "authorized_official_last_name": "LEMONS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "406-581-5181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MT",
            "license": "2236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.