Mountain Shadows Vision Center, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

CO1914 Issued in CO

Legal business name

MOUNTAIN SHADOWS VISION CENTER, LLC

Practice address

1910 Vindicator Dr Ste 102
Colorado Springs, CO 80919-3618

Phone

(719) 590-1744

NPI assigned

Sep 22, 2009

Last updated

Dec 31, 2020By 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

Karen Higashi-ReynoldsNPI 1528164589

Title

Manager

Phone

(719) 590-1744

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

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.

• Karen Lynn Higashi-Reynolds, O.D.

  • Optometrist
  • Colorado Springs, CO
  • NPI 1528164589
  Medicare reassignment Authorized official
• Mimi T NG, O.D.

  • Optometrist
  • Colorado Springs, CO
  • NPI 1710085840
  NPD (past)

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609372800000",
    "number": "1356675557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 VINDICATOR DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193618",
            "telephone_number": "719-590-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 VINDICATOR DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193618",
            "telephone_number": "719-590-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN SHADOWS VISION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A",
        "authorized_official_last_name": "HIGASHI-REYNOLDS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "719-590-1744"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "CO1914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountain Medical Specialists LLC
• Mountain Miracles Midwifery, Inc.
• Mountain Oasis Psychiatric Associates
• Mountain Ridge Hospice, LLC (Mountain Ridge Hospice)
• Mountain Shadows Family Dentistry, P.C.
• Mountain Sky Cardiology LLC
• Mountain Smiles Dentistry
• Mountain Smiles, PLLC (Musolf Dental Center)
• Mountain States Pathology PC
• Mountain States Pathology PC

• Optometrist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.