NPIMap

Organization Active NPI

Vista Optical

  • Optometrist
  • Cannon AFB, NM
National Provider Identifier
1295188050
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISTA OPTICAL
Practice address
102 W Octagon St
BLDG 77B
Cannon AFB, NM 88103-5207
Phone
(575) 904-1001
Fax
(575) 784-9722
NPI assigned
Jul 18, 2016
Last updated
Sep 17, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
NATIONAL VISION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Leahann Rene Vaughn
Title
Director
Phone
(470) 448-2782

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary
Optician 156FX1800X

Addresses

Primary practice location

102 W Octagon St
BLDG 77B
Cannon AFB, NM 88103-5207

Mailing address

2435 Commerce Ave
BLDG 2200
Duluth, GA 30096-4980
Phone (770) 822-3600

National Provider Directory

National Provider Directory
Tax ID family
Americas Best Contacts and Eyeglasses Inc1,621 organizations share this tax ID, including this one
Part of
Americas Best Contacts and Eyeglasses Inc

Organizations with this tax ID in the same state 10

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

102 Octagon St W
Bldg 77B
Cannon AFB, NM 88103
Phone (575) 904-1001

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1295188050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 COMMERCE AVE",
            "address_2": "BLDG 2200",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964980",
            "telephone_number": "770-822-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W OCTAGON ST",
            "address_2": "BLDG 77B",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "881035207",
            "telephone_number": "575-904-1001",
            "fax_number": "575-784-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA OPTICAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL VISION, INC.",
        "enumeration_date": "2016-07-18",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LEAHANN",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "470-448-2782"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cannon AFB, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.