Thornton Youth Vision, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

THORNTON YOUTH VISION, LLC

Practice address

9674 Washington St Unit 104
Thornton, CO 80229-2160

Phone

(303) 450-0184

NPI assigned

Nov 7, 2018

Organization subpart

No

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

Authorized official

Name

Amber Logan

Title

Business Manager

Phone

(719) 200-5623

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Matthew Thomas Peterson, O.D.

  • Optometrist
  • Denver, CO
  • NPI 1760796866
  NPD (past)

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1508334541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 GROVE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802042229",
            "telephone_number": "719-200-5623",
            "fax_number": "719-960-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9674 WASHINGTON ST UNIT 104",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292160",
            "telephone_number": "303-450-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THORNTON YOUTH VISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "719-200-5623"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000168991",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thornton Dental and Orthodontics, PLLC
• Thornton Medical Center, P.C.
• Thornton Surgical Specialists LLC
• Thornton Valley Dental
• Thornton Youth Dentistry, PC
• Debra Jane Thornton, NCC , LPC
• Tania Mendoza Thoroughgood, LPC, LPCC
• Riley Thorson
• Nicole Thoutt
• Three Peaks Counseling, LLC

• All providers in Thornton, CO
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.