Family First Vision Care Arizona PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

FAMILY FIRST VISION CARE ARIZONA PLLC

Practice address

21001 N Tatum Blvd Ste 18
Phoenix, AZ 85050-4207

Phone

(480) 513-4184

Fax

(480) 513-4184

NPI assigned

Jun 14, 2017

Last updated

Jan 31, 2023By 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

Nicole Jandernal

Title

Credentialing Manager

Phone

(732) 236-7067

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Family First Vision Care Arizona PLLC

  dba Pearle Vision

  • Optometrist
  • Phoenix, AZ
  • NPI 1639875826

  O20170906001731

  Same enrollment

Locations

Practitioners 33

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.

• Bryan Blare, O.D.

  • Optometrist
  • Mesa, AZ
  • NPI 1063409548
  NPD
• Alexander John Conati, OD

  • Optometrist
  • Tolleson, AZ
  • NPI 1467115626
  NPD
• Shale Lynn Demuth, OD

  • Optometrist
  • Tucson, AZ
  • NPI 1417704222
  NPD
• Sean Courtney Dennis

  • Optometrist
  • Phoenix, AZ
  • NPI 1568038693
  NPD
• Rachel Dickert, OD

  • Optometrist
  • Phoenix, AZ
  • NPI 1053838409
  NPD
• Priscilla Lee, O.D.

  • Optometrist
  • Prescott, AZ
  • NPI 1235126129
  NPD
• Matthew Ryan Lopez, O.D.

  • Optometrist
  • Tolleson, AZ
  • NPI 1477806255
  NPD
• Kelsey Jordan Palmer, OD

  • Optometrist
  • Peoria, AZ
  • NPI 1992462725
  NPD
• Marshall Dennis Palmer, O.D.

  • Optometrist
  • Safford, AZ
  • NPI 1932185758
  NPD
• Randall Carl Paul, O.D.

  • Optometrist
  • Phoenix, AZ
  • NPI 1376672303
  NPD
• Joanne Tang, OD

  • Optometrist
  • Peoria, AZ
  • NPI 1457735391
  NPD
• Diana Vega Hernandez, OD

  • Optometrist
  • Glendale, AZ
  • NPI 1013211598
  NPD

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1710417514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4680 PARKWAY DR STE 22",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408296",
            "telephone_number": "513-445-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD STE 18",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504207",
            "telephone_number": "480-513-4184",
            "fax_number": "480-513-4184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 W Dove Valley Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850855253",
            "country_code": "US",
            "telephone_number": "614-831-0268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10706 E Point Twenty-Two Blvd",
            "address_2": "#107",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "85212",
            "country_code": "US",
            "telephone_number": "904-545-4465",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24775 N. Pleasant Pkwy",
            "address_2": "#103",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "85383",
            "country_code": "US",
            "telephone_number": "904-545-4465",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15681 N Hayden Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "85260",
            "country_code": "US",
            "telephone_number": "480-591-0123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10629 N Scottsdale Rd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852545337",
            "country_code": "US",
            "telephone_number": "520-201-5120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7131 W Ray Rd",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852261520",
            "country_code": "US",
            "telephone_number": "520-201-3250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7870 W Bell Rd # 110",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853088621",
            "country_code": "US",
            "telephone_number": "904-545-4465",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "937 N Dobson Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852017589",
            "country_code": "US",
            "telephone_number": "480-649-6100",
            "fax_number": "480-649-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2475 S Val Vista Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852951214",
            "country_code": "US",
            "telephone_number": "904-545-4465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY FIRST VISION CARE ARIZONA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-14",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "JANDERNAL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "732-236-7067"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Dental Phoenix
• Family Doula Services LLC
• Family First Assisted Living Dba Golden Life
• Family First Hospice Inc
• Family First Vision Care Arizona PLLC (Pearle Vision)
• Family Institute for Health and Recovery
• Family Involvement Center
• Family Kare Walk-in Klinic LLC
• Family Matters Community Care, LLC
• Family Medical and Wellness Care, PLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.