Park Family Eyecare 2

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PARK FAMILY EYECARE 2

Practice address

4284 Spring Mountain Rd Unit 102
Las Vegas, NV 89102-8787

Phone

(702) 327-6329

NPI assigned

Dec 3, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Peter Park, ODNPI 1780808105

Title

Owner

Phone

(702) 573-9471

Specialties & licenses 1

Addresses

Other names 1

• Eleven Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Park, O.D.

  • Optometrist
  • Las Vegas, NV
  • NPI 1780808105
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1861097016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2188 ORCHARD MIST ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351562",
            "telephone_number": "702-573-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4284 SPRING MOUNTAIN RD UNIT 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891028787",
            "telephone_number": "702-327-6329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK FAMILY EYECARE 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-573-9471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eleven Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shirelle Paris
• Christina Parise
• Carina Parisey
• Peggy Parish
• Thomas Parisi, M.D.
• Park Family Eyecare Inc.
• Park Psychiatry PLLC
• Julie S Park-Chang, O.D.
• Allen Park, PA-C
• Anne Park, FNP

• Optometrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.