Northern Nevada Eyecare LTD

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

NORTHERN NEVADA EYECARE LTD

Practice address

50 E Haskell St., Suite a
Winnemucca, NV 89445-3576

Phone

(775) 623-5211

Fax

(775) 623-5236

NPI assigned

Jan 8, 2007

Last updated

Apr 26, 2017By 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

Dr. Fanny W Chan, O.D.

Title

Optometrist

Phone

(775) 623-5211

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1295883858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E HASKELL ST., SUITE A",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453576",
            "telephone_number": "775-623-5211",
            "fax_number": "775-623-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E HASKELL ST., SUITE A",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453576",
            "telephone_number": "775-623-5211",
            "fax_number": "775-623-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NEVADA EYECARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "FANNY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "775-623-5211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506146",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG9793",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nevada State Health Division/Far Nursin (Frontier and Rural Public Health)
• Nevada State Health Division/Far Nursin (Frontier and Rural Health Services)
• Krysta Mariel Ngo
• Silver L Nichols
• Northern Nevada Eyecare LTD
• Northern Nevada Human Services (Sonoma Industries)
• Northern Nevada Human Services (Sonoma Industries)
• Northstar Imaging Inc
• Northstar Radiology
• Tammy Lea Palm

• Optometrist in Winnemucca, NV
• Providers in Winnemucca, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.