Organization Active NPI

Advanced Eye Center, Inc

Doing business as Route 20/20 Vision Center

  • Optometrist
  • Locust Grove, VA
National Provider Identifier
1447410618
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001128 Issued in VA
Legal business name
ADVANCED EYE CENTER, INC
Doing business as
Route 20/20 Vision Center
Practice address
32511 Constitution Hwy
Locust Grove, VA 22508-2711
Phone
(540) 854-2255
NPI assigned
Jun 11, 2008
Last updated
Dec 9, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED EYE CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Authorized official

Name
Dr. Katherine A Klopfer, ODNPI 1396805784
Title
Doctor/President
Phone
(540) 854-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001128 VA Primary

Addresses

Primary practice location

32511 Constitution Hwy
Locust Grove, VA 22508-2711

Mailing address

PO Box 2616
Locust Grove, VA 22508-8616
Phone (540) 854-2255

Other identifiers 1

IdentifierTypeStateIssuer
1396805784MedicaidVA

Other names 1

  • Route 20/20 Vision Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081201000501 VA Part B Supplier - Clinic/Group Practice 2769543362 Receives reassigned benefits from 1 practitioner
Practice locations: Locust Grove, VA

National Provider Directory

National Provider Directory
Part of
Advanced Eye Center Inc

Locations

32345 Constitution Hwy
Ste H
Locust Grove, VA 22508
Phone (540) 854-2255

32511 Constitution Hwy
Locust Grove, VA 22508
Phone (540) 854-2255

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": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1447410618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2616",
            "city": "LOCUST GROVE",
            "state": "VA",
            "postal_code": "225088616",
            "telephone_number": "540-854-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32511 CONSTITUTION HWY",
            "city": "LOCUST GROVE",
            "state": "VA",
            "postal_code": "225082711",
            "telephone_number": "540-854-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYE CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED EYE CENTER, INC",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "KLOPFER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DOCTOR/PRESIDENT",
        "authorized_official_telephone_number": "540-854-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396805784",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Route 20/20 Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Locust Grove, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.