Organization Active NPI

Seville Eye Center LLC

  • Optometrist
  • Gilbert, AZ
National Provider Identifier
1750455234
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AZ01104 Issued in AZ
Legal business name
SEVILLE EYE CENTER LLC
Practice address
3336 E Chandler Heights Rd
BLDG a Ste 104
Gilbert, AZ 85298-4259
Phone
(480) 279-3937
Fax
(480) 889-2948
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2010

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

Authorized official

Name
Christopher C Carpenter, O.D.NPI 1538132311
Title
Optometrist
Phone
(480) 279-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X AZ01104 AZ Primary

Addresses

Primary practice location

3336 E Chandler Heights Rd
BLDG a Ste 104
Gilbert, AZ 85298-4259

Mailing address

3336 E Chandler Heights Rd
BLDG a Ste 104
Gilbert, AZ 85298-4259
Phone (480) 279-3937

Other identifiers 1

IdentifierTypeStateIssuer
539570MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070307000090 AZ Part B Supplier - Clinic/Group Practice 7214030527 Receives reassigned benefits from 4 practitioners
Practice locations: Gilbert, AZ

National Provider Directory

National Provider Directory

Locations

3336 E Chandler Heights Rd
Ste 101
Gilbert, AZ 85298
Phone (480) 412-5900

3336 E Chandler Heights Rd
#A104
Gilbert, AZ 85298

3336 E Chandler Heights Rd
Ste 104
Gilbert, AZ 85298
Phone (480) 279-3937

3336 E Chandler Heights Rd
Ste A101
Gilbert, AZ 85298
Phone (480) 279-3937

Practitioners & affiliated clinicians

Practitioners 4

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": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274054400000",
    "number": "1750455234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3336 E CHANDLER HEIGHTS RD",
            "address_2": "BLDG A STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852984259",
            "telephone_number": "480-279-3937",
            "fax_number": "480-889-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 E CHANDLER HEIGHTS RD",
            "address_2": "BLDG A STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852984259",
            "telephone_number": "480-279-3937",
            "fax_number": "480-889-2948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVILLE EYE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2010-05-17",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "480-279-3937",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "AZ01104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "539570",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.