NPIMap

Organization Active NPI

Morrison Optometric Associates, PA

Doing business as Vision Source of Burlington

  • Optometrist
  • Burlington, CO
National Provider Identifier
1851534705
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2649 Issued in CO
Legal business name
MORRISON OPTOMETRIC ASSOCIATES, PA
Doing business as
Vision Source of Burlington
Practice address
498 15TH St
Burlington, CO 80807-1624
Phone
(719) 346-8415
NPI assigned
Apr 8, 2009
Last updated
Apr 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Authorized official

Name
Mary Shoaff
Title
Practice Manager
Phone
(785) 462-8231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2649 CO Primary

Addresses

Primary practice location

498 15TH St
Burlington, CO 80807-1624

Mailing address

498 15TH St
Burlington, CO 80807-1624
Phone (719) 346-8415

Other identifiers 2

IdentifierTypeStateIssuer
CS8632OtherRAILROAD MEDICARE
76557758MedicaidCO

Other names 1

  • Vision Source of Burlington Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930036583 CO DME Supplier - Physician - Optometrist 8426005083 Practice locations: Burlington, CO

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Morrison Optometric Associates PA7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1851534705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 15TH ST",
            "city": "BURLINGTON",
            "state": "CO",
            "postal_code": "808071624",
            "telephone_number": "719-346-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 15TH ST",
            "city": "BURLINGTON",
            "state": "CO",
            "postal_code": "808071624",
            "telephone_number": "719-346-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRISON OPTOMETRIC ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-08",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "SHOAFF",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "785-462-8231"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CS8632",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76557758",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Source of Burlington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.