Active NPI
National Vision, Inc.
- Eyewear Supplier
- Logan, WV
National Provider Identifier
1376584201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- NATIONAL VISION, INC.
- Practice address
- 77 Norman Morgan Blvd
Logan, WV 25601-3477 - Phone
- (304) 752-2853
- NPI assigned
- Jun 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anna Purcell
- Title
- Provider Network Administrator
- Phone
- (770) 822-4245
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
77 Norman Morgan Blvd
Logan, WV 25601-3477
Mailing address
PO Box 951336
Dallas, TX 75395-1336
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0151470006 | Medicaid | WV |
National Provider Directory
National Provider DirectoryLocations
77 Norman Morgan Blvd
Logan, WV 25601
Phone (304) 752-2853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213574400000",
"number": "1376584201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 951336",
"city": "DALLAS",
"state": "TX",
"postal_code": "753951336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 NORMAN MORGAN BLVD",
"city": "LOGAN",
"state": "WV",
"postal_code": "256013477",
"telephone_number": "304-752-2853"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATIONAL VISION, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-10",
"last_updated": "2008-06-16",
"status": "A",
"authorized_official_last_name": "PURCELL",
"authorized_official_first_name": "ANNA",
"authorized_official_title_or_position": "PROVIDER NETWORK ADMINISTRATOR",
"authorized_official_telephone_number": "770-822-4245"
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0151470006",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Logan, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.