Organization Active NPI

Northwest Vision Center LLC

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1821368036
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NORTHWEST VISION CENTER LLC
Practice address
4343 N Rancho Dr
Suite 116
Las Vegas, NV 89130-3421
Phone
(702) 656-6144
Fax
(702) 656-3754
NPI assigned
Jan 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Authorized official

Name
Dr. Christopher Chiodo, ODNPI 1750435921
Title
Owner
Phone
(702) 656-6144

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 NV Primary

Addresses

Primary practice location

4343 N Rancho Dr
Suite 116
Las Vegas, NV 89130-3421

Mailing address

4343 N Rancho Dr
Las Vegas, NV 89130-3425
Phone (702) 656-6144

Other identifiers 1

IdentifierTypeStateIssuer
37228OtherNVMEDICARE ID - TYPE UNSPECIFIED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150925001507 NV Part B Supplier - Clinic/Group Practice 1951619857 Receives reassigned benefits from 5 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

4343 N Rancho Dr
Ste 116
Las Vegas, NV 89130
Phone (702) 656-6144

Practitioners & affiliated clinicians

Practitioners 6

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": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1821368036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 N RANCHO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303425",
            "telephone_number": "702-656-6144",
            "fax_number": "702-341-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 N RANCHO DR",
            "address_2": "SUITE 116",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303421",
            "telephone_number": "702-656-6144",
            "fax_number": "702-656-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST VISION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "CHIODO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-656-6144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "37228",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.