Organization Active NPI

Clear Vision, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1457692840
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
458635 Issued in TX
Legal business name
CLEAR VISION, LLC
Practice address
1222 N Main Ave Ste 740
San Antonio, TX 78212-5711
Phone
(210) 273-9931
NPI assigned
Mar 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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

Authorized official

Name
Ms. Rochelle L Staten, RN, MSN, MHSANPI 1679671523
Title
Sole Owner
Phone
(210) 273-9931

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 458635 TX Primary

Addresses

Primary practice location

1222 N Main Ave Ste 740
San Antonio, TX 78212-5711

Mailing address

9832 Logans Ridge Dr
Converse, TX 78109-2765
Phone (210) 273-9931

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130628000485 TX Part B Supplier - Clinic/Group Practice 8729228598 Receives reassigned benefits from 1 practitioner
Practice locations: Converse, TX

National Provider Directory

National Provider Directory

Locations

8930 Fourwinds Dr
#250
Windcrest, TX 78239
Phone (210) 273-9931

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1457692840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9832 LOGANS RIDGE DR",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781092765",
            "telephone_number": "210-273-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 N MAIN AVE STE 740",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125711",
            "telephone_number": "210-273-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR VISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-08",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "STATEN",
        "authorized_official_first_name": "ROCHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "210-273-9931",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MSN, MHSA"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "458635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.