NPIMap

Organization Active NPI

Your Childs Eyes LLC

Doing business as Academy Kids Vision

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1659975118
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
YOUR CHILDS EYES LLC
Doing business as
Academy Kids Vision
Practice address
2857 E Fountain Blvd
Colorado Springs, CO 80910-2312
Phone
(719) 329-1221
NPI assigned
Nov 25, 2020
Organization subpart
Yes
Parent organization
YOUR CHILDS EYES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Authorized official

Name
Shaun Urbanozo
Title
Credentialing Manager
Phone
(719) 323-2362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2857 E Fountain Blvd
Colorado Springs, CO 80910-2312

Mailing address

2221 E Bijou St Ste 100
Colorado Springs, CO 80909-8009
Phone (719) 576-1850

Other identifiers 1

IdentifierTypeStateIssuer
21351821MedicaidCO

Other names 1

  • Academy Kids Vision Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Your Child's Eyes LLC3 organizations share this tax ID, including this one
Part of
Your Child's Eyes LLC

Other organizations with this tax ID 2

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

Locations

2857 E Fountain Blvd
Colorado Springs, CO 80910
Phone (719) 329-1221

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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": "1606262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1659975118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809098009",
            "telephone_number": "719-576-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 E FOUNTAIN BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809102312",
            "telephone_number": "719-329-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR CHILDS EYES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YOUR CHILDS EYES LLC",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "URBANOZO",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-323-2362"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21351821",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Academy Kids Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.