Evergreen Vision Clinic, PC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1747 Issued in CO

Legal business name

EVERGREEN VISION CLINIC, PC

Practice address

30960 Stagecoach Blvd # W200
Evergreen, CO 80439-7902

Phone

(303) 674-4143

Fax

(303) 670-4081

NPI assigned

Oct 9, 2006

Last updated

Nov 2, 2007By 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

Daniel R. Hock, O.D.NPI 1235103227

Title

Optometrist

Phone

(303) 674-4143

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

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.

• Daniel R. Hock, O.D.

  • Optometrist
  • Evergreen, CO
  • NPI 1235103227
  Medicare reassignment NPD Authorized official
• Nicole Suzanne Wellensiek, O.D.

  • Optometrist
  • Lakewood, CO
  • NPI 1912109331
  Medicare reassignment NPD
• Donald Paul Kaiser, O.D.

  • Optometrist
  • Englewood, CO
  • NPI 1609902576
  NPD (past)
• Sarah Sandhaus, OD

  • Optometrist
  • Renton, WA
  • NPI 1194202622
  NPD (past)

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1487741542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30960 STAGECOACH BLVD # W200",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30960 STAGECOACH BLVD # W200",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397902",
            "telephone_number": "303-674-4143",
            "fax_number": "303-670-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN VISION CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "HOCK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "303-674-4143",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CO",
            "license": "1747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen Pediatrics, LLC (Evergreen Conifer Pediatrics)
• Evergreen Physical Therapy Specialists, PC
• Evergreen Psychotherapy Center
• Evergreen Spine and Sports Medicine LLC
• Evergreen Therapeutic Massage LLC
• Fabled Counseling
• Jennifer Faike, MS, OTR/L
• Christine Marrie Fale, B.S., CACIII
• Caryl Fank, P.T.A.
• Kathleen Farrell

• Eyewear Supplier in Evergreen, CO
• Providers in Evergreen, CO by specialty
• Eyewear Supplier in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.