Active NPI
Electric City Eyes
- Optometrist
- Great Falls, MT
National Provider Identifier
1619730249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Audra Sexton, O.D.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.