NPIMap

Organization Active NPI

Keen Eye Vision PLLC

  • Optometrist
  • Star, ID
National Provider Identifier
1861674707
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KEEN EYE VISION PLLC
Practice address
170 South Seneca Springs Way
Suite 100
Star, ID 83669
Phone
(208) 898-4112
NPI assigned
Dec 3, 2007
Last updated
Dec 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Dr. Jeffrey Paul Graviet, O.D.NPI 1831148105
Title
Owner
Phone
(208) 286-7296

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

170 South Seneca Springs Way
Suite 100
Star, ID 83669

Mailing address

457 N Hannah PL
Star, ID 83669-5640

National Provider Directory

National Provider Directory

Locations

170 S Seneca Springs Way
#100
Star, ID 83669
Phone (208) 898-4112

Practitioners & affiliated clinicians

Practitioners 3

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": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1861674707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 N HANNAH PL",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836695640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 SOUTH SENECA SPRINGS WAY",
            "address_2": "SUITE 100",
            "city": "STAR",
            "state": "ID",
            "postal_code": "83669",
            "telephone_number": "208-898-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEEN EYE VISION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "GRAVIET",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-286-7296",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Star, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.