New Visions Optical, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

03695969 Issued in MD

Legal business name

NEW VISIONS OPTICAL, INC.

Practice address

5310 Edmondson Ave
Baltimore, MD 21229-2201

Phone

(443) 315-5945

Fax

(800) 670-8788

NPI assigned

Jun 12, 2013

Last updated

Jul 1, 2013By 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

Mr. Santana Lavon Nottage

Title

President/Ceo

Phone

(443) 315-5945

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1659719631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 EDMONDSON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212292201",
            "telephone_number": "443-315-5945",
            "fax_number": "800-670-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 EDMONDSON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212292201",
            "telephone_number": "443-315-5945",
            "fax_number": "800-670-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW VISIONS OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "NOTTAGE",
        "authorized_official_first_name": "SANTANA",
        "authorized_official_middle_name": "LAVON",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "443-315-5945",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "03695969",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MD",
            "license": "03695969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.