NPIMap

Organization Active NPI

Gem Vision, PC

  • Optometrist
  • Emmett, ID
National Provider Identifier
1336734326
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GEM VISION, PC
Practice address
316 S Washington Ave
Emmett, ID 83617-2952
Phone
(208) 365-8865
NPI assigned
Mar 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Christopher Kimball, ODNPI 1265988810
Title
Owner
Phone
(208) 365-8865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

316 S Washington Ave
Emmett, ID 83617-2952

Mailing address

316 S Washington Ave
Emmett, ID 83617-2952
Phone (208) 365-8865

Other names 1

  • Gem Vision Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210420001882 ID Part B Supplier - Clinic/Group Practice 1456769033 Receives reassigned benefits from 1 practitioner
Practice locations: Emmett, ID
O20210604000345 ID DME Supplier - Physician - Optometrist 1456769033 Practice locations: Emmett, ID

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
Gem Vision, PC316 S Washington Ave, Emmett, ID 83617-2952(208) 369-4883 Ocular Prostheses|Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Apr 14, 2021

National Provider Directory

National Provider Directory

Locations

316 S Washington Ave
Emmett, ID 83617
Phone (208) 343-8907

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1336734326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S WASHINGTON AVE",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836172952",
            "telephone_number": "208-365-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S WASHINGTON AVE",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836172952",
            "telephone_number": "208-365-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEM VISION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-365-8865",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gem Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gem Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Emmett, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.