NPIMap

Organization Active NPI

Vistar Eye Center, Inc

  • Eyewear Supplier
  • Rocky Mount, VA
National Provider Identifier
1871028209
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
VISTAR EYE CENTER, INC
Practice address
395 S Main St
Rocky Mount, VA 24151-1710
Phone
(540) 855-5100
NPI assigned
Apr 24, 2017
Last updated
Apr 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Authorized official

Name
Staci Elaine Runyon
Title
Managed Care
Phone
(540) 855-3554

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary
Optometrist 152W00000X 0618001837 VA

Addresses

Primary practice location

395 S Main St
Rocky Mount, VA 24151-1710

Mailing address

PO Box 1789
Roanoke, VA 24008-1789
Phone (540) 855-5100

Other names 1

  • Vistar Rocky Mount Optical Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1871028209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1789",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240081789",
            "telephone_number": "540-855-5100",
            "fax_number": "540-342-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 S MAIN ST",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241511710",
            "telephone_number": "540-855-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTAR EYE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-24",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "RUNYON",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "MANAGED CARE",
        "authorized_official_telephone_number": "540-855-3554"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001837",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vistar Rocky Mount Optical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rocky Mount, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.