NPIMap

Organization Active NPI

C. Jack Roffis OD, PC

  • Optometrist
  • Boulder, CO
National Provider Identifier
1801023296
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1277 Issued in CO
Legal business name
C. JACK ROFFIS OD, PC
Practice address
1933 28TH St
Suite 206
Boulder, CO 80301-1100
Phone
(303) 447-8470
Fax
(303) 443-9555
NPI assigned
Jun 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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

Authorized official

Name
Dr. C. Jack Roffis, ODNPI 1881633352
Title
President
Phone
(303) 447-8470

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 1277 CO Primary

Addresses

Primary practice location

1933 28TH St
Suite 206
Boulder, CO 80301-1100

Mailing address

1933 28TH St
Suite 206
Boulder, CO 80301-1100
Phone (303) 447-8470

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1244764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244764800000",
    "number": "1801023296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 28TH ST",
            "address_2": "SUITE 206",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011100",
            "telephone_number": "303-447-8470",
            "fax_number": "303-443-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 28TH ST",
            "address_2": "SUITE 206",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011100",
            "telephone_number": "303-447-8470",
            "fax_number": "303-443-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. JACK ROFFIS OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-12",
        "last_updated": "2009-06-12",
        "status": "A",
        "authorized_official_last_name": "ROFFIS",
        "authorized_official_first_name": "C. JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-447-8470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; 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.