Organization Active NPI

Ian Kawamoto, OD LLC

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1942325634
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
512 Issued in NV
Legal business name
IAN KAWAMOTO, OD LLC
Practice address
4825 S Rainbow Blvd
Ste. 203
Las Vegas, NV 89103-4914
Phone
(702) 252-7310
Fax
(702) 252-7320
NPI assigned
Mar 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ian Kawamoto, O.D.
Title
Managing Member
Phone
(702) 252-7310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 512 NV Primary

Addresses

Primary practice location

4825 S Rainbow Blvd
Ste. 203
Las Vegas, NV 89103-4914

Mailing address

4825 S Rainbow Blvd
Ste. 203
Las Vegas, NV 89103-4914
Phone (702) 252-7310

National Provider Directory

National Provider Directory

Locations

4825 S Rainbow Blvd
Ste 203
Las Vegas, NV 89103
Phone (702) 252-7310

Practitioners & affiliated clinicians

Practitioners 1

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942325634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 S RAINBOW BLVD",
            "address_2": "STE. 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034914",
            "telephone_number": "702-252-7310",
            "fax_number": "702-252-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 S RAINBOW BLVD",
            "address_2": "STE. 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034914",
            "telephone_number": "702-252-7310",
            "fax_number": "702-252-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAN KAWAMOTO, OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAWAMOTO",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-252-7310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.