Organization Active NPI

Troy Humphreys, OD

  • Optometrist
  • Reno, NV
National Provider Identifier
1629840319
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TROY HUMPHREYS, OD
Practice address
9120 Double Diamond Pkwy
Reno, NV 89521-4842
Phone
(775) 391-6433
Fax
(775) 391-6450
NPI assigned
Oct 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Troy Humphreys, ODNPI 1992712194
Title
Ceo/Owner
Phone
(775) 287-0295

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

9120 Double Diamond Pkwy
Reno, NV 89521-4842

Mailing address

2435 Primio CT
Sparks, NV 89434-9589
Phone (775) 287-0295

Other names 1

  • Legacy Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240126001029 NV Part B Supplier - Clinic/Group Practice 9638522691 Receives reassigned benefits from 3 practitioners
Practice locations: Reno, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1698192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1629840319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 PRIMIO CT",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349589",
            "telephone_number": "775-287-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 DOUBLE DIAMOND PKWY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895214842",
            "telephone_number": "775-391-6433",
            "fax_number": "775-391-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROY HUMPHREYS, OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-25",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "HUMPHREYS",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "775-287-0295",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.