Impact Vision Therapy, P.C.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

2985 Issued in CO

Legal business name

IMPACT VISION THERAPY, P.C.

Practice address

595 Chapel Hills Dr
Ste 101
Colorado Springs, CO 80920-1022

Phone

(719) 302-8922

NPI assigned

Jul 8, 2014

Organization subpart

No

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

Authorized official

Name

Joshua Watt

Title

President

Phone

(719) 302-8922

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1376959585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 CHAPEL HILLS DR",
            "address_2": "STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 CHAPEL HILLS DR",
            "address_2": "STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201022",
            "telephone_number": "719-302-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT VISION THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "WATT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-302-8922"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "CO",
            "license": "2985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.