NPIMap

Organization Active NPI

3D Vision, Inc

  • Optometrist
  • Pueblo, CO
National Provider Identifier
1881063303
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0002603 Issued in CO
Legal business name
3D VISION, INC
Practice address
4080 W Northern Ave
Pueblo, CO 81005-3503
Phone
(719) 551-7337
NPI assigned
Sep 15, 2015
Last updated
Dec 4, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
3D VISION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Jenni Drake Jr.NPI 1629278049
Title
Owner
Phone
(719) 676-2100

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
Optometrist 152W00000X OPT.0002603 CO Primary

Addresses

Primary practice location

4080 W Northern Ave
Pueblo, CO 81005-3503

Mailing address

4080 W Northern Ave
Pueblo, CO 81005-3503
Phone (719) 551-7337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091002000247 CO Part B Supplier - Clinic/Group Practice 0042356123 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Broomfield, CO; Colorado City, CO; Pueblo, CO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
3D Vision Inc3 organizations share this tax ID, including this one
Part of
3D Vision Inc

Other organizations with this tax ID 2

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

Locations

5760 W 120th Ave
Broomfield, CO 80020
Phone (303) 404-3937

5760 W 120th Ave
Ste 240
Broomfield, CO 80020
Phone (303) 239-3937

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1881063303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 W NORTHERN AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053503",
            "telephone_number": "719-551-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 W NORTHERN AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053503",
            "telephone_number": "719-551-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3D VISION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "3D VISION, INC",
        "enumeration_date": "2015-09-15",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "JENNI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-676-2100",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0002603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.