Academy Kids Vision Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ACADEMY KIDS VISION CENTER LLC

Doing business as

Academy Kids Dental Vision and Orthodontics

Practice address

2436 S Academy Blvd
Colorado Springs, CO 80916-2408

Phone

(719) 391-2336

Fax

(719) 391-1625

NPI assigned

Jun 11, 2008

Last updated

Apr 29, 2021By 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

Ms. Samantha B Leblanc

Title

Credentialing Specialist

Phone

(719) 323-2372

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Academy Kids Dental Vision and Orthodontics Doing business as

Tax ID family

Academy Kids Vision Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Academy Kids Vision Center LLC

  dba Adventure Vision

  • Optometrist
  • Colorado Springs, CO
  • NPI 1902400468
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Academy Kids Vision Center LLC

  dba Adventure Vision

  • Optometrist
  • Colorado Springs, CO
  • NPI 1902400468
  NPPES parent name

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1639339930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST.",
            "address_2": "STE. 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80909",
            "telephone_number": "719-391-2336",
            "fax_number": "719-391-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2436 S ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162408",
            "telephone_number": "719-391-2336",
            "fax_number": "719-391-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMY KIDS VISION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "719-323-2372",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25100343",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Academy Kids Dental Vision and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Academy Ear Nose Throat /Allergy Clinic
• Academy Heights Foot Clinic PC (Colorado Springs Foot & Ankle Clinic)
• Academy Heights Foot Clinic PC (Colorado Springs Foot and Ankle Clinic)
• Academy Kids Dental Center PC (Academy Kids Dental, Vision and Orthodontics)
• Academy Kids Dental Center PC (Academy Kids Dental, Vision and Orthodontics)
• Academy Kids Vision Center LLC (Adventure Vision)
• Academy Laser Dentistry PC
• Academy Vision Science Clinic PC
• Academy Womens Healthcare Associates PC
• Accelerate-Ip LLC

• Clinic/Center in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.