Classic Eyewear, Inc

Primary specialty

OpticianTaxonomy code 156FX1800X

License

437 Issued in NM

Legal business name

CLASSIC EYEWEAR, INC

Practice address

113 W Broadway
Farmington, NM 87401-6419

Phone

(505) 326-2020

Fax

(505) 327-5530

NPI assigned

May 15, 2008

Last updated

Sep 25, 2013By 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. Raymond P Herrera, O.D.NPI 1134132228

Title

Owner

Phone

(505) 326-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 4

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.

• Raymond P Herrera, O.D.

  • Optometrist
  • Farmington, NM
  • NPI 1134132228
  Medicare reassignment Care Compare group NPD Authorized official
• Amanda Colburn, O.D.

  • Optometrist
  • Farmington, NM
  • NPI 1134522493
  Medicare reassignment Care Compare group NPD
• Ralph W Lightle, O.D.

  • Optometrist
  • Farmington, NM
  • NPI 1215053327
  Medicare reassignment NPD
• Roger Marvin Allyn, O.D.

  • Optometrist
  • La Plata, NM
  • NPI 1093979874
  Medicare reassignment

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1447427638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W BROADWAY",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016419",
            "telephone_number": "505-326-2020",
            "fax_number": "505-327-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W BROADWAY",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016419",
            "telephone_number": "505-326-2020",
            "fax_number": "505-327-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC EYEWEAR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "HERRERA",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-326-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NM",
            "license": "437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P2124",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Dee Clark, D.D.S.
• Diamond Darlene Clark, RN
• Jeffrey C Clark, D.D.S.
• Stephen B Clark, DDS,MS
• Brett M. Clarke, MD
• Cloud 9 Sleep Center
• Stella Mae Cly
• Jane Cobb
• Morgan Cochran, PT, DPT
• Kandice M Cochrane, LMT

• Optician in Farmington, NM
• Providers in Farmington, NM by specialty
• Optician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.