NPIMap

Organization Active NPI

Vision One Inc

  • Optometrist
  • Boise, ID
National Provider Identifier
1821168907
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISION ONE INC
Practice address
610 Americana Blvd
Boise, ID 83702-6731
Phone
(208) 344-2020
Fax
(208) 344-2371
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Dr. Gregory N Bodily, ODNPI 1013008614
Title
Owner President
Phone
(208) 344-2020

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 Primary

Addresses

Primary practice location

610 Americana Blvd
Boise, ID 83702-6731

Mailing address

610 Americana Blvd
Boise, ID 83702-6731
Phone (208) 344-2020

Other identifiers 3

IdentifierTypeStateIssuer
V8446OtherIDBLUECROSS
000010015543OtherIDBLUESHIELD
002605600MedicaidID

Other names 1

  • Vision One Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061215000146 ID Part B Supplier - Clinic/Group Practice 2668471889 Receives reassigned benefits from 2 practitioners
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Locations

610 S Americana Blvd
Boise, ID 83702
Phone (208) 344-2020

Practitioners & affiliated clinicians

Practitioners 9

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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1821168907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 AMERICANA BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026731",
            "telephone_number": "208-344-2020",
            "fax_number": "208-344-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 AMERICANA BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026731",
            "telephone_number": "208-344-2020",
            "fax_number": "208-344-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION ONE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "BODILY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "208-344-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "V8446",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "000010015543",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002605600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision One",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.