Chico Vision Care Optometry Group

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 5613 TPL Issued in CA

Legal business name

CHICO VISION CARE OPTOMETRY GROUP

Practice address

2109 Forest Ave
Suite 50
Chico, CA 95928-7680

Phone

(530) 342-9644

Fax

(530) 342-7547

NPI assigned

Dec 19, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Obbie Pennington, O.D.

Title

Partner

Phone

(530) 342-9644

Specialties & licenses 1

Addresses

Other identifiers 5

Interoperability endpoints

• Direct secure messaging: edlim@chicovisioncare.eyefinity-direct.com
• Direct secure messaging: obbiepennington@chicovisioncare.eyefinity-direct.com

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Louie Lim, O.D.

  • Optometrist
  • Chico, CA
  • NPI 1104896372
  NPD
• Randall B Watkins, O.D.

  • Optometrist
  • Chico, CA
  • NPI 1396721692
  NPD (past)

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1275519571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 FOREST AVE",
            "address_2": "SUITE 50",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287680",
            "telephone_number": "530-342-9644",
            "fax_number": "530-342-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 FOREST AVE",
            "address_2": "SUITE 50",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287680",
            "telephone_number": "530-342-9644",
            "fax_number": "530-342-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICO VISION CARE OPTOMETRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "PENNINGTON",
        "authorized_official_first_name": "OBBIE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "530-342-9644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 5613 TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0056130",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0060770",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD",
            "identifier": "46196",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "CV07521",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "116313",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chico State Enterprises
• Chico State University, Student Health Service
• Chico Surgery Center LP
• Chico Terrace Healthcare & Wellness Centre, LP
• Chico Unified SCH Ool District
• Winyan Washte Chief, MFT
• Michael Childers
• Elizabeth Claire Childress
• Sumendeep Kaur Chima, RN
• Dorothy I Chinnock, NP

• Optometrist in Chico, CA
• Providers in Chico, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.