Trendsetters Optical LLC

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

TRENDSETTERS OPTICAL LLC

Practice address

324 N Massey Blvd
Nixa, MO 65714-8307

Phone

(417) 725-0303

NPI assigned

Nov 21, 2006

Last updated

Jun 16, 2008By 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

Mr. Jack Newman

Title

Owner

Phone

(870) 577-1076

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1780759472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 N MASSEY BLVD",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148307",
            "telephone_number": "417-725-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 N MASSEY BLVD",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148307",
            "telephone_number": "417-725-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRENDSETTERS OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-577-1076",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310813951",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329359111",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optician in Nixa, MO
• Providers in Nixa, MO by specialty
• Optician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.