Jason Bolenbaker, O.D., PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

479 Issued in NV

Legal business name

JASON BOLENBAKER, O.D., PC

Doing business as

Visionary Eye Center

Practice address

8175 S Virginia St # B900
Reno, NV 89511-8922

Phone

(775) 827-1100

Fax

(775) 827-1138

NPI assigned

Nov 29, 2006

Last updated

Jun 9, 2009By 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. Jason Allan Bolenbaker, O.D.NPI 1851315212

Title

President

Phone

(775) 827-1100

Specialties & licenses 1

Addresses

Other names 1

• Visionary Eye Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

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

CLIA laboratory certificates

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.

• Jason Allan Bolenbaker, O.D.

  • Optometrist
  • Reno, NV
  • NPI 1851315212
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1457428989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 S VIRGINIA ST # B900",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895118922",
            "telephone_number": "775-827-1100",
            "fax_number": "775-827-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 S VIRGINIA ST # B900",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895118922",
            "telephone_number": "775-827-1100",
            "fax_number": "775-827-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON BOLENBAKER, O.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "BOLENBAKER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "775-827-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visionary Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ripal Bharatkumar Jariwala, PHARM.D.
• David R Jarrett, D.D.S.
• Derrin E Jarvis, PA-C
• Steven Courtlandt Jarzembowski
• Linda Jarzynka, RPH
• Jason Champagne II PLLC
• Jason Champagne III PLLC
• Jason Champagne IX PLLC (Childrens Dentistry Of Reno)
• Jason Champagne VIII PLLC (Sierra Kids Dentistry)
• Jordan Elizabeth Jasper

• Optometrist in Reno, NV
• Providers in Reno, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.