Organization Active NPI

Eye Care Professionals

  • Non-Pharmacy Dispensing Site
  • Reno, NV
National Provider Identifier
1679931687
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
9064 Issued in NV
Legal business name
EYE CARE PROFESSIONALS
Practice address
10685 Professional Cir
Suite a
Reno, NV 89521-5856
Phone
(775) 322-1000
NPI assigned
Feb 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Jasmine Worthen
Title
Credentialing Specialist
Phone
(727) 755-0693

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 9064 NV Primary

Addresses

Primary practice location

10685 Professional Cir
Suite a
Reno, NV 89521-5856

Mailing address

311 Park Place Blvd
5TH Floor
Clearwater, FL 33759-4904
Phone (727) 755-0693

Other identifiers 1

IdentifierTypeStateIssuer
100506279MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
Eye Care Professionals2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1679931687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PARK PLACE BLVD",
            "address_2": "5TH FLOOR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594904",
            "telephone_number": "727-755-0693",
            "fax_number": "727-755-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10685 PROFESSIONAL CIR",
            "address_2": "SUITE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215856",
            "telephone_number": "775-322-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "WORTHEN",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "727-755-0693"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NV",
            "license": "9064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506279",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.