Individual provider Active NPI

Jonathan Mark Christiansen, O.D.

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1750306395
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
550 Issued in NV
Practice address
4485 S Pecos Rd
Las Vegas, NV 89121-5029
Phone
(702) 737-0097
NPI assigned
Jul 13, 2006
Last updated
Sep 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 550 NV Primary

Addresses

Primary practice location

4485 S Pecos Rd
Las Vegas, NV 89121-5029

Mailing address

1196 Brockley Cross St
Henderson, NV 89002-3362
Phone (714) 356-8451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060828000418 NV Practitioner - Optometry 4688678063 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pritchett Eye Care PC Optometrist CurrentSince Dec 1, 2016 Accepting new patients
Pritchett Eye Care PC Optometrist Current Accepting new patients
Pritchett Eye Care PC Optometrist CurrentSince Dec 1, 2016 Accepting new patients
Century Vision Center, CHTD. Optometrist Past Accepting new patients
Douglas D Lee OD LTD Optometrist Past Accepting new patients
Pritchett Eye Care PC Optometrist Past Accepting new patients
Pritchett Eye Care PC Optometrist Past Accepting new patients

Locations

1627 Boulder City Pkwy
Boulder City, NV 89005
Phone (702) 294-2227

143 S Water St
Henderson, NV 89015
Phone (702) 944-9446

10870 W Charleston Blvd
Ste 105
Las Vegas, NV 89135
Phone (702) 877-3937

4485 S Pecos Rd
Las Vegas, NV 89121
Phone (702) 737-0097

8230 W Sahara Ave
Ste 121
Las Vegas, NV 89117
Phone (702) 944-2001

1601 E Basin Ave
Ste 101
Pahrump, NV 89060
Phone (775) 751-1791

5961 S Los Altos Pkwy
Ste 101
Sparks, NV 89436
Phone (775) 359-2020

Interoperability endpoints

  • Direct secure messaging: jon.christiansen@direct.revolutionehr.com

Organizations & group practices 25

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1750306395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1196 BROCKLEY CROSS ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890023362",
            "telephone_number": "714-356-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 S PECOS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215029",
            "telephone_number": "702-737-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIANSEN",
        "first_name": "JONATHAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.