Organization Active NPI

Visionary Optometry

  • Optometrist
  • Vista, CA
National Provider Identifier
1396924809
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10767T Issued in CA
Legal business name
VISIONARY OPTOMETRY
Practice address
640 Escondido Ave
Suite 114
Vista, CA 92084-6172
Phone
(760) 630-8200
Fax
(760) 630-8288
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Authorized official

Name
Dr. Ken Lay, OD
Title
Optometrist/Owner
Phone
(760) 630-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10767T CA Primary

Addresses

Primary practice location

640 Escondido Ave
Suite 114
Vista, CA 92084-6172

Mailing address

640 Escondido Ave
Suite 114
Vista, CA 92084-6172
Phone (760) 630-8200

Other names 1

  • n/a Doing business as

National Provider Directory

National Provider Directory

Locations

30 Main St
Ste 140
Vista, CA 92083
Phone (760) 630-8200

640 Civic Center Dr
Ste 114
Vista, CA 92084
Phone (760) 630-8200

640 Civic Center Dr
Ste 11
Vista, CA 92084
Phone (760) 630-8200

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272412800000",
    "number": "1396924809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 ESCONDIDO AVE",
            "address_2": "SUITE 114",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920846172",
            "telephone_number": "760-630-8200",
            "fax_number": "760-630-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ESCONDIDO AVE",
            "address_2": "SUITE 114",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920846172",
            "telephone_number": "760-630-8200",
            "fax_number": "760-630-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2010-04-28",
        "status": "A",
        "authorized_official_last_name": "LAY",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "760-630-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10767T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; 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.