West Valley Vision Center, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

A160 Issued in AK

Legal business name

WEST VALLEY VISION CENTER, INC

Practice address

4169 Geist Rd
Fairbanks, AK 99709-3420

Phone

(907) 479-4700

Fax

(907) 457-5596

NPI assigned

Apr 13, 2007

Last updated

Jun 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jamie Boyle

Title

Office Manager

Phone

(907) 479-4700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barbara M Keys, OD

  • Optometrist
  • Fairbanks, AK
  • NPI 1235298134
  Medicare reassignment Care Compare group NPD
• Brannon Mills, O.D.

  • Optometrist
  • Anchorage, AK
  • NPI 1689795304
  Medicare reassignment Care Compare group NPD
• Ashley Elizabeth Norum Ellis, O.D.

  • Optometrist
  • Oklahoma City, OK
  • NPI 1700239126

  AK

  Medicare reassignment Care Compare group NPD
• Michael J Mavencamp, OD

  • Optometrist
  • Fairbanks, AK
  • NPI 1760541676
  Medicare reassignment Care Compare group
• Catherine G Furey, OD

  • Optometrist
  • Glendale, AZ
  • NPI 1316667454
  NPD (past)
• Michael T Furey

  • Optometrist
  • Goodyear, AZ
  • NPI 1841928835
  NPD (past)
• Michael Brayden Lundquist, OD, FAAO, FSLS

  • Corneal and Contact Management Optometrist
  • Goodyear, AZ
  • NPI 1013390285
  NPD (past)
• Dean Lawrence Mallory

  • Optometrist
  • Goodyear, AZ
  • NPI 1801517206
  NPD (past)
• Tyler Von Mullen, OD

  • Optometrist
  • Goodyear, AZ
  • NPI 1366963647
  NPD (past)
• Brent J Wilson, OD

  • Optometrist
  • Goodyear, AZ
  • NPI 1063491660
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1235354515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 RIVERSTONE WAY",
            "address_2": "SUITE 3",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997092939",
            "telephone_number": "907-479-4700",
            "fax_number": "907-457-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4169 GEIST RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093420",
            "telephone_number": "907-479-4700",
            "fax_number": "907-457-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VALLEY VISION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "907-479-4700"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AK",
            "license": "A160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Zane Wentz, DDS, MS
• Zachary R Werle, D.O.
• Aaron Wernham, MD
• Jessica Lauren Wert
• Pamela Sue Wescott, MA
• Parrish West
• Shauna Nicole West
• Western Colorado Professional Neuromonitoring
• Western Colorado Technical Neuromonitoring, LLC
• Grayson Thomas Westfall, M.D.

• Optometrist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Optometrist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.