Organization Active NPI

Nationwide Vision Center, Inc.

  • Optician
  • Lake Havasu City, AZ
National Provider Identifier
1336593656
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
NATIONWIDE VISION CENTER, INC.
Practice address
5651 Highway 95 N
Inside Jcpenney
Lake Havasu City, AZ 86404-9646
Phone
(928) 764-2385
NPI assigned
Apr 22, 2016
Last updated
Dec 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Joseph Pravoot Gira, MDNPI 1861481152
Title
Chief Medical Officer
Phone
(314) 909-0633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X AZ Primary

Addresses

Primary practice location

5651 Highway 95 N
Inside Jcpenney
Lake Havasu City, AZ 86404-9646

Mailing address

955 W Southern Ave Ste 101
Mesa, AZ 85210-4903
Phone (480) 961-1865

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1461283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1336593656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W SOUTHERN AVE STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104903",
            "telephone_number": "480-961-1865",
            "fax_number": "480-893-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 HIGHWAY 95 N",
            "address_2": "INSIDE JCPENNEY",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864049646",
            "telephone_number": "928-764-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONWIDE VISION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-22",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "GIRA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "PRAVOOT",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "314-909-0633",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.