NPIMap

Organization Active NPI

Blink LLC

Doing business as Lakepointe Vision Center

  • Optometrist
  • O'Fallon, IL
National Provider Identifier
1629187208
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008912 Issued in IL
Legal business name
BLINK LLC
Doing business as
Lakepointe Vision Center
Practice address
1003 E Wesley Dr
Ste a
O Fallon, IL 62269-6137
Phone
(618) 624-3937
Fax
(618) 624-3940
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Authorized official

Name
Dr. David Eghigian, OD
Title
Owner
Phone
(618) 624-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046008912 IL Primary

Addresses

Primary practice location

1003 E Wesley Dr
Ste a
O Fallon, IL 62269-6137

Mailing address

1003 E Wesley Dr
Ste a
O Fallon, IL 62269-6137
Phone (618) 624-3937

Other names 1

  • Lakepointe Vision Center Doing business as

National Provider Directory

National Provider Directory

Locations

1003 E Wesley Dr
Ste A
O Fallon, IL 62269
Phone (618) 624-3937

Practitioners & affiliated clinicians

Practitioners 5

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1629187208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 E WESLEY DR",
            "address_2": "STE A",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696137",
            "telephone_number": "618-624-3937",
            "fax_number": "618-624-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E WESLEY DR",
            "address_2": "STE A",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696137",
            "telephone_number": "618-624-3937",
            "fax_number": "618-624-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLINK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "EGHIGIAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-624-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakepointe Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O'Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.