NPIMap

Organization Active NPI

Eyezone, Inc.

  • Optometrist
  • Stateline, NV
National Provider Identifier
1487822201
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
278 Issued in NV
Legal business name
EYEZONE, INC.
Practice address
276 Kingsbury Grade
Suite 103
Stateline, NV 89449-7170
Phone
(775) 588-3500
Fax
(775) 588-6045
NPI assigned
Feb 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Dr. Mark Michitsch, OPTOMETRISTNPI 1043249394
Title
Owner
Phone
(775) 588-3500

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 278 NV Primary

Addresses

Primary practice location

276 Kingsbury Grade
Suite 103
Stateline, NV 89449-7170

Mailing address

PO Box 7170
Stateline, NV 89449-7170
Phone (775) 588-3500

National Provider Directory

National Provider Directory
Tax ID family
Alpine Eyecare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1487822201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7170",
            "city": "STATELINE",
            "state": "NV",
            "postal_code": "894497170",
            "telephone_number": "775-588-3500",
            "fax_number": "775-588-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 KINGSBURY GRADE",
            "address_2": "SUITE 103",
            "city": "STATELINE",
            "state": "NV",
            "postal_code": "894497170",
            "telephone_number": "775-588-3500",
            "fax_number": "775-588-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEZONE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "MICHITSCH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-588-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OPTOMETRIST"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stateline, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.