Precision Vision Az LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PRECISION VISION AZ LLC

Practice address

4000 Old Court Rd
Suite 204
Pikesville, MD 21208-2800

Phone

(410) 653-2400

Fax

(602) 535-3165

NPI assigned

Nov 30, 2016

Organization subpart

Yes

Parent organization

SOUTH MOUNTAIN EYECAREAs reported in NPPES

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

Authorized official

Name

Dr. Selvin Gnanakkan, OD

Title

Optometrist/President

Phone

(602) 770-9300

Specialties & licenses 3

Addresses

Other names 1

• Precision Vision Doing business as

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1215470836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 REGINA DR",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212272342",
            "telephone_number": "410-653-2400",
            "fax_number": "602-535-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OLD COURT RD",
            "address_2": "SUITE 204",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082800",
            "telephone_number": "410-653-2400",
            "fax_number": "602-535-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION VISION AZ LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH MOUNTAIN EYECARE",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "GNANAKKAN",
        "authorized_official_first_name": "SELVIN",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "602-770-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Precision Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chayla Alexis Powers
• Layeska Prado Lopez
• Aleshia Leigh Pratt
• Ashle Pratt
• Precision Vision
• Precision Vision Corporation
• Malya Raizel Prero, OTR/L
• Patricia L. Prescott, P.T.
• Noelle Pressley, RN
• Izabel Luz Preston

• Optometrist in Pikesville, MD
• Providers in Pikesville, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.