Organization Active NPI

Demers Family Vision Group, Inc.

  • Optometrist
  • Sparks, NV
National Provider Identifier
1649388794
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
556 Issued in NV
Legal business name
DEMERS FAMILY VISION GROUP, INC.
Practice address
4874 Sparks Blvd
Sparks, NV 89436-8206
Phone
(775) 358-1317
NPI assigned
Aug 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
Dr. Leslie Lynne Demers, ODNPI 1487769030
Title
Vice President
Phone
(775) 358-1317

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 556 NV Primary

Addresses

Primary practice location

4874 Sparks Blvd
Sparks, NV 89436-8206

Mailing address

670 N McCarran Blvd
Sparks, NV 89431-4600
Phone (775) 358-1317

Other identifiers 1

IdentifierTypeStateIssuer
1649388794OtherNVNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070227000788 NV Part B Supplier - Clinic/Group Practice 2860594488 Receives reassigned benefits from 5 practitioners
Practice locations: Sparks, NV
O20100930035585 NV DME Supplier - Physician - OptometristDME Supplier - Optician 2860594488 Practice locations: Sparks, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Demers Family Vision Group Inc4874 Sparks Blvd, Sparks, NV 89436(775) 358-1317 Ocular Prostheses|Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2008

National Provider Directory

National Provider Directory

Locations

670 N McCarran Blvd
Sparks, NV 89431
Phone (775) 358-1317

Practitioners & affiliated clinicians

Practitioners 6

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": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1649388794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 N MCCARRAN BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894314600",
            "telephone_number": "775-358-1317",
            "fax_number": "775-355-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4874 SPARKS BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894368206",
            "telephone_number": "775-358-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMERS FAMILY VISION GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "DEMERS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "775-358-1317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": "556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649388794",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.