Organization Active NPI

Skyline Vision Optical LLC

  • Eyewear Supplier
  • Canon City, CO
National Provider Identifier
1316497456
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SKYLINE VISION OPTICAL LLC
Practice address
2776 E Main St
Canon City, CO 81212-4010
Phone
(719) 275-1523
Fax
(719) 275-6925
NPI assigned
Oct 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Authorized official

Name
Ashley Harmon
Title
Director
Phone
(719) 630-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

2776 E Main St
Canon City, CO 81212-4010

Mailing address

2776 E Main St
Canon City, CO 81212-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170414000141 CO DME Supplier - Physician - Optometrist 6901182500 Practice locations: Canon City, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Skyline Vision Optical2776 E Main St, Canon City, CO 81212-4010(719) 275-1523 Prosthetic Lenses: Conventional Eyeglasses Does not accept assignmentParticipating since Dec 5, 2016

National Provider Directory

National Provider Directory
Tax ID family
Skyline Vision Optical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1316497456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2776 E MAIN ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 E MAIN ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124010",
            "telephone_number": "719-275-1523",
            "fax_number": "719-275-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE VISION OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "HARMON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "719-630-3937"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.