NPIMap

Organization Active NPI

First Sight Vision Care LLC

  • Clinic/Center
  • Fulton, MD
National Provider Identifier
1235489030
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FIRST SIGHT VISION CARE LLC
Practice address
8160 Maple Lawn Blvd
Suite 140
Fulton, MD 20759
Phone
(443) 804-1173
NPI assigned
Sep 19, 2012
Last updated
Nov 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Authorized official

Name
Dr. Nutaporn Sukontasup, O.D.NPI 1104930817
Title
Owner/Principal
Phone
(443) 804-1173

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
Clinic/Center 261Q00000X MD Primary

Addresses

Primary practice location

8160 Maple Lawn Blvd
Suite 140
Fulton, MD 20759

Mailing address

8315 Academy Rd
Ellicott City, MD 21043-6687
Phone (443) 804-1173

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121113000143 MD Part B Supplier - Clinic/Group Practice 3375794787 Receives reassigned benefits from 4 practitioners
Practice locations: Fulton, MD

National Provider Directory

National Provider Directory

Locations

8115 Maple Lawn Blvd
Ste 135
Fulton, MD 20759
Phone (301) 490-3036

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1235489030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8315 ACADEMY RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436687",
            "telephone_number": "443-804-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8160 MAPLE LAWN BLVD",
            "address_2": "SUITE 140",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "20759",
            "telephone_number": "443-804-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST SIGHT VISION CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "SUKONTASUP",
        "authorized_official_first_name": "NUTAPORN",
        "authorized_official_title_or_position": "OWNER/PRINCIPAL",
        "authorized_official_telephone_number": "443-804-1173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.