Eyeland, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1490 Issued in CO

Legal business name

EYELAND, P.C.

Doing business as

Citadel Vision Center

Practice address

3510 Galley Rd Ste 101
Colorado Springs, CO 80909-4353

Phone

(719) 597-4423

NPI assigned

Dec 4, 2007

Last updated

Dec 18, 2008By 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

Dr. Stephen Roark, O.D.NPI 1083659015

Title

Ceo

Phone

(719) 597-4423

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Citadel Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Eyeland, P.C.

  dba Eagle Eyes Vision Center South

  • Optometrist
  • Colorado Springs, CO
  • NPI 1477735132

  O20200727000420

  Same enrollment
• Eyeland, P.C.

  dba Eagle Eyes Vision Center North

  • Optometrist
  • Colorado Springs, CO
  • NPI 1538341722

  O20200727000420

  Same enrollment

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.

• Stephen Ray Roark, O.D

  • Optometrist
  • Colorado Springs, CO
  • NPI 1083659015
  Medicare reassignment Care Compare group Authorized official
• Jordan Lee Mayhew, OD

  • Optometrist
  • Colorado Springs, CO
  • NPI 1245723162
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229558400000",
    "number": "1386826048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 GALLEY RD STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094353",
            "telephone_number": "719-597-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 GALLEY RD STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094353",
            "telephone_number": "719-597-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYELAND, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2008-12-18",
        "status": "A",
        "authorized_official_last_name": "ROARK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "719-597-4423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04015913",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citadel Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eye Love Care Inc
• Eye Love Care Inc
• Eye Love Care Inc
• Eye Specialists of Colorado
• Eye Specialists of Colorado LLC
• Eyeland, P.C. (Eagle Eyes Vision Center South)
• Eyeland, P.C. (Eagle Eyes Vision Center North)
• Eyemart Express LLC
• Milla Eyre
• Eyrie Dale Healthcare, Inc. (Springs Village Care Center)

• 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 18, 2008; 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.