Organization Active NPI

Vision Associates Inc

  • Optometrist
  • Ruston, LA
National Provider Identifier
1902933435
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
927-032T Issued in LA
Legal business name
VISION ASSOCIATES INC
Doing business as
Vision Center
Practice address
911 Tech Drive
Ruston, LA 71270-0701
Phone
(318) 251-9095
Fax
(318) 251-1705
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Dr. Gary J Avallone, ODNPI 1457300261
Title
Secretary Treasurer
Phone
(318) 251-9095

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 927-032T LA Primary

Addresses

Primary practice location

911 Tech Drive
Ruston, LA 71270-0701

Mailing address

911 Tech Drive
Ruston, LA 71270-0701
Phone (318) 251-9095

Other identifiers 1

IdentifierTypeStateIssuer
1346870MedicaidLA

Other names 1

  • Vision Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081017000710 LA Part B Supplier - Clinic/Group Practice 9537227640 Receives reassigned benefits from 2 practitioners
Practice locations: Ruston, LA

National Provider Directory

National Provider Directory

Locations

911 Tech Dr
Ruston, LA 71270
Phone (318) 251-9095

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1902933435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 TECH DRIVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712700701",
            "telephone_number": "318-251-9095",
            "fax_number": "318-251-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 TECH DRIVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712700701",
            "telephone_number": "318-251-9095",
            "fax_number": "318-251-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "AVALLONE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SECRETARY TREASURER",
        "authorized_official_telephone_number": "318-251-9095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "927-032T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346870",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ruston, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.