NPIMap

Organization Active NPI

La Mesa Vision Care Center Optometry

  • Optometrist
  • La Mesa, CA
National Provider Identifier
1396931176
Registry record updated Jan 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 7490 TPA Issued in CA
Legal business name
LA MESA VISION CARE CENTER OPTOMETRY
Practice address
8007 La Mesa Blvd
La Mesa, CA 91941-6434
Phone
(619) 466-5665
Fax
(619) 466-5688
NPI assigned
Sep 14, 2007
Last updated
Jan 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2009

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

Authorized official

Name
Dr. Thomas M Hixson, O.D.NPI 1528072683
Title
Owner
Phone
(619) 466-5665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT 7490 TPA CA Primary

Addresses

Primary practice location

8007 La Mesa Blvd
La Mesa, CA 91941-6434

Mailing address

8007 La Mesa Blvd
La Mesa, CA 91941-6434
Phone (619) 466-5665

Other identifiers 2

IdentifierTypeStateIssuer
SD0113620MedicaidCA
SD0074900MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230854400000",
    "number": "1396931176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8007 LA MESA BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919416434",
            "telephone_number": "619-466-5665",
            "fax_number": "619-466-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8007 LA MESA BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919416434",
            "telephone_number": "619-466-5665",
            "fax_number": "619-466-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MESA VISION CARE CENTER OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2009-01-02",
        "status": "A",
        "authorized_official_last_name": "HIXSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-466-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 7490 TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0113620",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0074900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; 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.