NPIMap

Organization Active NPI

National Vision, Inc.

  • Optometrist
  • Albuquerque, NM
National Provider Identifier
1720133549
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NATIONAL VISION, INC.
Practice address
4200 Wyoming Boulevard NE
Albuquerque, NM 87111
Phone
(505) 294-0955
Fax
(505) 294-0950
NPI assigned
Jan 24, 2007
Organization subpart
Yes
Parent organization
NATIONAL VISION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Leahann Rene Vaughn
Title
Director
Phone
(470) 448-2782

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X FA0051597 NM
Eyewear Supplier 332H00000X

Addresses

Primary practice location

4200 Wyoming Boulevard NE
Albuquerque, NM 87111

Mailing address

296 Grayson Highway
Lawrenceville, GA 30046
Phone (770) 822-3600

Other names 1

  • EyeGlass World Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wal Mart Vision Ctr 2141,614 organizations share this tax ID, including this one
Part of
Wal Mart Vision Ctr 214

Organizations with this tax ID in the same state 10

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1720133549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 GRAYSON HIGHWAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-822-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WYOMING BOULEVARD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87111",
            "telephone_number": "505-294-0955",
            "fax_number": "505-294-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL VISION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL VISION, INC.",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LEAHANN",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "470-448-2782"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NM",
            "license": "FA0051597",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EyeGlass World",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EyeGlass World",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.