Peak Vision Canon City Prof, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PEAK VISION CANON CITY PROF, LLC

Practice address

2776 E Main St
Canon City, CO 81212-4010

Phone

(719) 275-1523

Fax

(719) 275-6925

NPI assigned

Aug 31, 2006

Last updated

Jun 12, 2023By 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. Britt A. Buckley, M.D.

Title

Owner

Phone

(719) 275-1523

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 5

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.

• Dana Reilly Hill, OD

  • Optometrist
  • Colorado Springs, CO
  • NPI 1780160325
  Medicare reassignment Care Compare group NPD
• Philip L Hwang, O.D.

  • Optometrist
  • Colorado Springs, CO
  • NPI 1588004642
  Medicare reassignment Care Compare group NPD
• Ryan John Anderson, OD

  • Optometrist
  • Colorado Springs, CO
  • NPI 1639927130
  Medicare reassignment NPD
• Sidney Brent Goodwin, O.D.

  • Corneal and Contact Management Optometrist
  • Canon City, CO
  • NPI 1750541009
  Medicare reassignment NPD
• Michael L. Streeter, OD

  • Optometrist
  • Fort Carson, CO
  • NPI 1598334898
  Medicare reassignment NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1326159492",
    "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",
            "telephone_number": "719-275-1523",
            "fax_number": "719-275-6925"
        },
        {
            "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": "PEAK VISION CANON CITY PROF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "BRITT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-275-1523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89850092",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Wayne Paschall, P.T.
• Christine Renee Patterson, MSW
• Jacob F Patterson
• Marion M Patterson, RN
• Anna Kristin Payne, RDN
• Basil Eugene Pearson, D.C.
• Lisa G Pearson, DNAP, CRNA, NSPMC
• Pediatric Associates of Canon City, Prof. LLC
• Raymond J Pelland, PA-C
• Jody L Pendleton, LPC

• Optometrist in Canon City, CO
• Providers in Canon City, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.