Provision LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2030-IOD Issued in WV

Legal business name

PROVISION LLC

Practice address

306 Southridge Blvd
South Charleston, WV 25309-9434

Phone

(304) 744-4017

Fax

(304) 744-4018

NPI assigned

Jan 17, 2017

Organization subpart

No

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

Authorized official

Name

David Beecher, OD

Title

Owner

Phone

(304) 744-4017

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Louis J Stanley, O.D.

  • Optometrist
  • South Charleston, WV
  • NPI 1053526855
  NPD

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508371200000",
    "number": "1609312537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 SOUTHRIDGE BLVD",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253099434",
            "telephone_number": "304-744-4017",
            "fax_number": "304-744-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 SOUTHRIDGE BLVD",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253099434",
            "telephone_number": "304-744-4017",
            "fax_number": "304-744-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-10-19",
        "status": "A",
        "authorized_official_last_name": "BEECHER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-744-4017",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "2030-IOD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beulah Pritt
• Linda Pritt
• Stephanie Pritt
• Debra Procious
• Progressivehealth Healthspot, LLC (City of South Charleston Employee Health Clinic)
• Lindsay Prowse
• Jaliyah Pruitt
• Psycare Inc (TMS Center of West Virginia)
• Monica Renee Puderbaugh, D.D.S.
• Brenda G. Pugh, CRNA

• Optometrist in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.