Lander Vision Source PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

LANDER VISION SOURCE PC

Practice address

556 Main St
Lander, WY 82520-3032

Phone

(307) 332-2020

Fax

(307) 332-5718

NPI assigned

Jul 25, 2023

Organization subpart

No

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

Authorized official

Name

Kortny C Lancaster, ODNPI 1699401182

Title

Owner

Phone

(307) 389-7722

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Kortny Clayton Lancaster, OD

  • Optometrist
  • Lander, WY
  • NPI 1699401182
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1902587751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 MAIN ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203032",
            "telephone_number": "307-332-2020",
            "fax_number": "307-332-5718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 MAIN ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203032",
            "telephone_number": "307-332-2020",
            "fax_number": "307-332-5718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDER VISION SOURCE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "LANCASTER",
        "authorized_official_first_name": "KORTNY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-389-7722",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lander Valley Medical Center LLC
• Lander Valley Medical Center LLC
• Lander Valley Physician Practices, LLC
• Lander Valley Sleep Lab LLC
• Lander Vision Center, PC
• Lander Womens Care LLC
• Angela L Laplante, C.O.T.A.
• Dayna K Latorre
• Ernest Troy Lawson
• Robert Lee, DPT,PT

• Optometrist in Lander, WY
• Providers in Lander, WY by specialty
• Optometrist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.