Countryside Optical

Primary specialty

OpticianTaxonomy code 156FX1800X

License

1101-001527 Issued in VA

Legal business name

COUNTRYSIDE OPTICAL

Practice address

20 Pidgeon Hill Dr
Suite 107
Sterling, VA 20165-6154

Phone

(703) 444-8500

Fax

(703) 406-3801

NPI assigned

Jun 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Francisco Altamirano, DO

Title

President

Phone

(703) 444-8500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700829553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PIDGEON HILL DR",
            "address_2": "SUITE 107",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656154",
            "telephone_number": "703-444-8500",
            "fax_number": "703-406-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PIDGEON HILL DR",
            "address_2": "SUITE 107",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656154",
            "telephone_number": "703-444-8500",
            "fax_number": "703-406-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALTAMIRANO",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-444-8500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "VA",
            "license": "1101-001527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Pharmacy 218
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Countryside Chiropractic Inc
• Beatrice Craiu, PSYD
• Cranial Technologies Inc
• Erin Whitney Crawford, PA-C
• Joanne Crenshaw, MD
• Ryan Crenshaw, MD PC

• Optician in Sterling, VA
• Providers in Sterling, VA by specialty
• Optician in Virginia

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