NPIMap

Organization Active NPI

Anasazi Eyecare Dba Visionwest

  • Optometrist
  • Los Alamos, NM
National Provider Identifier
1376670992
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ANASAZI EYECARE DBA VISIONWEST
Practice address
800 Trinity Dr Ste J
Los Alamos, NM 87544-4105
Phone
(505) 662-7000
NPI assigned
Feb 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Wende W Waggoner
Title
Doctor
Phone
(505) 662-7000

Specialties & licenses 1

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

Addresses

Primary practice location

800 Trinity Dr Ste J
Los Alamos, NM 87544-4105

Mailing address

800 Trinity Dr Ste J
Los Alamos, NM 87544-4105

National Provider Directory

National Provider Directory
Tax ID family
Anasazi Eyecare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376670992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TRINITY DR STE J",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875444105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TRINITY DR STE J",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875444105",
            "telephone_number": "505-662-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANASAZI EYECARE DBA VISIONWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGGONER",
        "authorized_official_first_name": "WENDE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "505-662-7000"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.