Magic Valley Vision PLLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

ODP-1036 Issued in ID

Legal business name

MAGIC VALLEY VISION PLLC

Practice address

1952 Addison Ave E
Twin Falls, ID 83301-5304

Phone

(208) 749-1396

NPI assigned

Jul 5, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Kay Ruprecht, O.D.NPI 1942376058

Title

Optometrist/Sole Owner

Phone

(208) 749-1396

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Kay Ruprecht, O.D.

  • Optometrist
  • Twin Falls, ID
  • NPI 1942376058
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341446400000",
    "number": "1730444779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 ADDISON AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015304",
            "telephone_number": "208-749-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 ADDISON AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015304",
            "telephone_number": "208-749-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGIC VALLEY VISION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-07-05",
        "status": "A",
        "authorized_official_last_name": "RUPRECHT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OPTOMETRIST/SOLE OWNER",
        "authorized_official_telephone_number": "208-749-1396",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "ID",
            "license": "ODP-1036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010139897",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Magic Valley Urology PLLC
• Magic Valley Womens Health Clinic, PLLC
• Murali Maheswaran, DO
• Anna Makovec-Fuller, CFNP
• Martha Maldonado, PA-C
• Dara Maltos

• Eyewear Supplier in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Eyewear Supplier in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; 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.