NPIMap

Organization Active NPI

Total Vision Optometric Center, P.C.

  • Optometrist
  • Woodbridge, VA
National Provider Identifier
1235311580
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001424 Issued in VA
Legal business name
TOTAL VISION OPTOMETRIC CENTER, P.C.
Practice address
4160 Merchant PLZ
Woodbridge, VA 22192-5085
Phone
(703) 878-8818
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Dr. Elisabeth Keunrok Kim, O.D.NPI 1154469070
Title
President
Phone
(703) 878-8878

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 MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 0618001424 VA Primary

Addresses

Primary practice location

4160 Merchant PLZ
Woodbridge, VA 22192-5085

Mailing address

4160 Merchant PLZ
Woodbridge, VA 22192-5085
Phone (703) 878-8818

National Provider Directory

National Provider Directory

Locations

4160 Merchant Plz
Woodbridge, VA 22192
Phone (703) 878-8818

Practitioners & affiliated clinicians

Practitioners 1

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": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1235311580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 MERCHANT PLZ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925085",
            "telephone_number": "703-878-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 MERCHANT PLZ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925085",
            "telephone_number": "703-878-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL VISION OPTOMETRIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_middle_name": "KEUNROK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-878-8878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.