Organization Active NPI

Electric City Eyes

  • Optometrist
  • Great Falls, MT
National Provider Identifier
1619730249
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ELECTRIC CITY EYES
Practice address
905 10TH Ave S
Great Falls, MT 59405-4420
Phone
(406) 204-0074
Fax
(406) 204-0075
NPI assigned
Feb 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Authorized official

Name
Dr. Audra Sexton, O.D.NPI 1104175314
Title
Optometrist
Phone
(605) 484-9760

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 Primary

Addresses

Primary practice location

905 10TH Ave S
Great Falls, MT 59405-4420

Mailing address

3604 2ND Ave S
Great Falls, MT 59405-3559
Phone (406) 204-0074

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240806004026 MT Part B Supplier - Clinic/Group Practice 4688111719 Receives reassigned benefits from 1 practitioner
Practice locations: Great Falls, MT

National Provider Directory

National Provider Directory

Locations

905 10th Ave S
Great Falls, MT 59405
Phone (406) 204-0074

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": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1619730249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 2ND AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594053559",
            "telephone_number": "406-204-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 10TH AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054420",
            "telephone_number": "406-204-0074",
            "fax_number": "406-204-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELECTRIC CITY EYES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "SEXTON",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "605-484-9760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.