NPIMap

Organization Active NPI

Eye Specialists of Colorado LLC

  • Specialist
  • Colorado Springs, CO
National Provider Identifier
1811076466
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
EYE SPECIALISTS OF COLORADO LLC
Practice address
3245 International Cir Ste 102
Colorado Springs, CO 80910-3152
Phone
(719) 633-8000
Fax
(719) 434-8855
NPI assigned
Nov 3, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Charles Dewey McMahon, MDNPI 1639168735
Title
Ownerophthalmologist
Phone
(719) 633-8000

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Technician/Technologist 156F00000X NU
Specialist 174400000X NU Primary
Ophthalmology Physician 207W00000X 188 CO

Addresses

Primary practice location

3245 International Cir Ste 102
Colorado Springs, CO 80910-3152

Mailing address

PO Box 280
Colorado Springs, CO 80901-0280
Phone (719) 440-0058

Other identifiers 1

IdentifierTypeStateIssuer
04015764MedicaidCO

Other names 1

  • Charles D McMahon MD LLC dba St Lukes Eye Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Charles D McMahon MD LLC Dba St Lukes Eye Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1811076466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809010280",
            "telephone_number": "719-440-0058",
            "fax_number": "719-636-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 INTERNATIONAL CIR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103152",
            "telephone_number": "719-633-8000",
            "fax_number": "719-434-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SPECIALISTS OF COLORADO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DEWEY",
        "authorized_official_title_or_position": "OWNEROPHTHALMOLOGIST",
        "authorized_official_telephone_number": "719-633-8000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "188",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04015764",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles D McMahon MD LLC dba St Lukes Eye Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.