Clovis Vision Associates PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

291 Issued in NM

Legal business name

CLOVIS VISION ASSOCIATES PA

Practice address

1217 Pile St
Clovis, NM 88101-5944

Phone

(575) 763-5522

Fax

(575) 763-4722

NPI assigned

Sep 1, 2005

Last updated

Mar 28, 2014By 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

Dr. Thomas Gregory Willmon, O.D.NPI 1215917323

Title

Partner

Phone

(575) 763-5522

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: drdewitt@clovisvision.eyefinity-direct.com

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Gregory Willmon, O.D.

  • Optometrist
  • Clovis, NM
  • NPI 1215917323
  Medicare reassignment Care Compare group NPD Authorized official
• Diane C Dewitt, O.D.

  • Optometrist
  • Clovis, NM
  • NPI 1265412639
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1669466900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 700",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881020700",
            "telephone_number": "575-763-5522",
            "fax_number": "575-763-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 PILE ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881015944",
            "telephone_number": "575-763-5522",
            "fax_number": "575-763-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVIS VISION ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "WILLMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "575-763-5522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM00P428",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clovis Quickcare LLC
• Clovis Surgery Center LLC
• Clovis Surgery Center LLC
• Clovis Surgery Center NM LLC
• Clovis VA Outpatient Care Clinic
• Krista B. Clower
• Bristi Nichole Coffey
• Janice Coffman
• Briana Nicole Cohen
• Sylvia Cohen

• Optometrist in Clovis, NM
• Providers in Clovis, NM by specialty
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.