Organization Active NPI

Southside Eyecare, LLC

  • Optometrist
  • Anchorage, AK
National Provider Identifier
1245403377
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SOUTHSIDE EYECARE, LLC
Practice address
9350 Independence Dr
Anchorage, AK 99507-4613
Phone
(907) 561-1167
Fax
(907) 561-7051
NPI assigned
Apr 9, 2008
Last updated
Mar 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Angie Benavides
Title
Office Administrator
Phone
(907) 561-1167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

9350 Independence Dr
Anchorage, AK 99507-4613

Mailing address

9350 Independence Dr
Anchorage, AK 99507-4613
Phone (907) 561-1167

National Provider Directory

National Provider Directory

Locations

9350 Independence Dr
Anchorage, AK 99507
Phone (907) 561-1167

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": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1245403377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 INDEPENDENCE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074613",
            "telephone_number": "907-561-1167",
            "fax_number": "907-561-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 INDEPENDENCE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995074613",
            "telephone_number": "907-561-1167",
            "fax_number": "907-561-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "BENAVIDES",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "907-561-1167"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.