Provision Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001394 Issued in VA

Legal business name

PROVISION EYE CARE, LLC

Practice address

10212 Staples Mill Rd
Glen Allen, VA 23060-3064

Phone

(804) 756-2020

Fax

(804) 447-6885

NPI assigned

Apr 10, 2017

Organization subpart

No

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

Authorized official

Name

Adam MeltonNPI 1588788905

Title

President

Phone

(804) 756-2020

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 8

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

• Adam Scott Melton, O.D.

  • Optometrist
  • Glen Allen, VA
  • NPI 1588788905
  Medicare reassignment NPD Authorized official
• Jennifer Lynn Trabosh, RDH

  • Dental Hygienist
  • Glen Allen, VA
  • NPI 1144982786
  NPD
• Maria Isabel Correa Giraldo, DDS

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1508476300
  NPD (past)
• Steven Gerard Forte, DDS

  • Endodontics
  • Midlothian, VA
  • NPI 1578671053
  NPD (past)
• Diane N Iachini, DDS

  • General Practice Dentistry
  • Richmond, VA
  • NPI 1346560117
  NPD (past)
• Steven K Larkin, DDS

  • Dentist
  • Glen Allen, VA
  • NPI 1245382878
  NPD (past)
• Denver James Lyons, DDS

  • Periodontics
  • Richmond, VA
  • NPI 1023539301
  NPD (past)
• David Stanley Wozniak, ENDODONTIST DDS

  • Endodontics
  • Henrico, VA
  • NPI 1194944884
  NPD (past)

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1306379003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10212 STAPLES MILL RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603064",
            "telephone_number": "804-756-2020",
            "fax_number": "804-447-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10212 STAPLES MILL RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603064",
            "telephone_number": "804-756-2020",
            "fax_number": "804-447-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-756-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001394",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "VA",
            "license": "0618001394",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Glen Allen, VA
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.