Capella Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

License

1466 Issued in AZ

Legal business name

CAPELLA EYECARE

Practice address

12625 N Saguaro Blvd
Suite 106
Fountain Hills, AZ 85268-4183

Phone

(480) 656-2111

Fax

(480) 621-8879

NPI assigned

Nov 15, 2012

Last updated

Mar 26, 2014By 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

Ha Anh Pham-Jibben, OD

Title

Doctor

Phone

(480) 656-2111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

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.

• H. Anh Pham Jibben, O.D.

  • Optometrist
  • Fountain Hills, AZ
  • NPI 1841481652
  Medicare reassignment NPD

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1407190598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 N SAGUARO BLVD",
            "address_2": "SUITE 106",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852684183",
            "telephone_number": "480-656-2111",
            "fax_number": "480-621-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 N SAGUARO BLVD",
            "address_2": "SUITE 106",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852684183",
            "telephone_number": "480-656-2111",
            "fax_number": "480-621-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPELLA EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "PHAM-JIBBEN",
        "authorized_official_first_name": "HA",
        "authorized_official_middle_name": "ANH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "480-656-2111",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Campos Lewis
• Rita Canales
• Catherine Lynn Cancino
• Hailee Cantrell
• Crystal Hien Hanh Cao-Baker, OTR/L
• Cardinal Home Care, LLC
• Care Imaging and Diagnosis Limited
• Adasiah Carlson
• Kristyn Carlson
• Gino Terry Carmolli, OD

• Optometrist in Fountain Hills, AZ
• Providers in Fountain Hills, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.