Fornara Eye Care

Primary specialty

OptometristTaxonomy code 152W00000X

License

1943 Issued in AZ

Legal business name

FORNARA EYE CARE

Practice address

21655 N Lake Pleasant Pkwy
Peoria, AZ 85382-7436

Phone

(928) 300-6339

NPI assigned

Mar 4, 2014

Last updated

Mar 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jason Wesley Fornara, OD

Title

Doctor

Phone

(928) 300-6339

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1629493341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5351 W KERRY LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084954",
            "telephone_number": "928-300-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21655 N LAKE PLEASANT PKWY",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827436",
            "telephone_number": "928-300-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORNARA EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "FORNARA",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "WESLEY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "928-300-6339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.