NPIMap

Organization Active NPI

Vail Vision PC

Doing business as Vail Vision

  • Optometrist
  • Edwards, CO
National Provider Identifier
1346498458
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
859 Issued in CO
Legal business name
VAIL VISION PC
Doing business as
Vail Vision
Practice address
1140 Edwards Village Blvd B206
Edwards, CO 81632
Phone
(970) 926-8484
NPI assigned
Sep 3, 2008
Last updated
Jan 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Dennis Dale Page, O.D.NPI 1801857289
Title
Owner/Optometrist
Phone
(970) 926-8474

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 859 CO Primary

Addresses

Primary practice location

1140 Edwards Village Blvd B206
Edwards, CO 81632

Mailing address

PO Box 544
1140 Edwards Village Blvd B206
Edwards, CO 81632-0544
Phone (970) 926-8474

Other names 1

  • Vail Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081111000563 CO Part B Supplier - Clinic/Group Practice 6204995855 Receives reassigned benefits from 7 practitioners
Practice locations: Edwards, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1346498458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 544",
            "address_2": "1140 EDWARDS VILLAGE BLVD B206",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816320544",
            "telephone_number": "970-926-8474",
            "fax_number": "970-926-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 EDWARDS VILLAGE BLVD B206",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "81632",
            "telephone_number": "970-926-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAIL VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "970-926-8474",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vail Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edwards, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.