NPIMap

Organization Active NPI

Anasazi Eyecare LLC

  • Optometrist
  • Los Alamos, NM
National Provider Identifier
1902081458
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ANASAZI EYECARE LLC
Practice address
800 Trinity Dr Ste J
Los Alamos, NM 87544-4105
Phone
(505) 662-7000
Fax
(505) 662-2949
NPI assigned
Jan 3, 2008
Last updated
Jan 3, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
WPEC , INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Authorized official

Name
Dr. Wende Waggoner
Title
President
Phone
(505) 662-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

800 Trinity Dr Ste J
Los Alamos, NM 87544-4105

Mailing address

800 Trinity Dr Ste J
Los Alamos, NM 87544-4105
Phone (505) 662-7000

National Provider Directory

National Provider Directory
Tax ID family
Anasazi Eyecare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1902081458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TRINITY DR STE J",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875444105",
            "telephone_number": "505-662-7000",
            "fax_number": "505-662-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TRINITY DR STE J",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875444105",
            "telephone_number": "505-662-7000",
            "fax_number": "505-662-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANASAZI EYECARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WPEC , INC.",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "WAGGONER",
        "authorized_official_first_name": "WENDE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-662-7000",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.