NPIMap

Organization Active NPI

Advanced Vision Therapy Center LLC

  • Vision Therapy Optometrist
  • Boise, ID
National Provider Identifier
1669808846
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
Legal business name
ADVANCED VISION THERAPY CENTER LLC
Practice address
7960 W Rifleman St
Suite 150
Boise, ID 83704-9064
Phone
(208) 377-1310
Fax
(208) 321-1952
NPI assigned
Sep 19, 2013
Last updated
Sep 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Authorized official

Name
Kendall Johnson
Title
Manager
Phone
(208) 377-1310

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Vision Optometrist 152WS0006X
Vision Therapy Optometrist 152WV0400X Primary

Addresses

Primary practice location

7960 W Rifleman St
Suite 150
Boise, ID 83704-9064

Mailing address

7960 W Rifleman St
Suite 150
Boise, ID 83704-9064
Phone (208) 377-1310

National Provider Directory

National Provider Directory

Locations

7960 W Rifleman St
Ste 150
Boise, ID 83704
Phone (208) 377-1310

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379548800000",
    "number": "1669808846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 W RIFLEMAN ST",
            "address_2": "SUITE 150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049064",
            "telephone_number": "208-377-1310",
            "fax_number": "208-321-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 W RIFLEMAN ST",
            "address_2": "SUITE 150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049064",
            "telephone_number": "208-377-1310",
            "fax_number": "208-321-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VISION THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-09-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-377-1310"
    },
    "taxonomies": [
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.