White Mountain Eye Care Center PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

858 Issued in AZ

Legal business name

WHITE MOUNTAIN EYE CARE CENTER PC

Practice address

176 N Main St
Snowflake, AZ 85937-5054

Phone

(928) 536-4000

Fax

(928) 536-5287

NPI assigned

Jan 14, 2009

Last updated

May 21, 2009By 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. George Elden Blair, ODNPI 1952376899

Title

Owner/Partner

Phone

(928) 536-4000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ2 enrollments

Enrollment records 2

Locations

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.

• George Elden Blair, OD

  • Optometrist
  • Snowflake, AZ
  • NPI 1952376899
  Medicare reassignment NPD Authorized official
• Ryan Craig Stuart, O.D.

  • Optometrist
  • Holbrook, AZ
  • NPI 1316912868
  NPD (past)

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242864000000",
    "number": "1679710529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 N MAIN ST",
            "city": "SNOWFLAKE",
            "state": "AZ",
            "postal_code": "859375054",
            "telephone_number": "928-536-4000",
            "fax_number": "928-536-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 N MAIN ST",
            "city": "SNOWFLAKE",
            "state": "AZ",
            "postal_code": "859375054",
            "telephone_number": "928-536-4000",
            "fax_number": "928-536-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MOUNTAIN EYE CARE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-05-21",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "ELDEN",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "928-536-4000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Lee Venditto, PHD
• Julia Lindzee Watson, M.S. SLP
• Valerie Webb, RN
• Craig Reed West, DDS
• White Mountain Dentistry
• Kenneth L. Wiltbank, D.C.
• Carol Lynn Winters, LCPC LPC CRC
• Debra Wood
• Justin James Woodside, D.C.
• Connie Marie Worthcota, COTA

• Optometrist in Snowflake, AZ
• Providers in Snowflake, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.