Ryan Peterson O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

532 Issued in NV

Legal business name

RYAN PETERSON O.D., INC.

Doing business as

Family Focused Eyecare

Practice address

2208 S Rainbow Blvd
Las Vegas, NV 89146-2976

Phone

(702) 876-0320

Fax

(702) 876-3095

NPI assigned

Jul 17, 2006

Last updated

Feb 10, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Kent Peterson, O.D.NPI 1902864614

Title

Owner

Phone

(702) 299-6200

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• FAMILY FOCUSED EYECARE Doing business as

Tax ID family

Ryan Peterson OD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Ryan Peterson O.D., Inc.

  • Optometrist
  • Las Vegas, NV
  • NPI 1194247015
  NPD tax ID

Locations

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.

• Ryan Kent Peterson, O.D.

  • Optometrist
  • Henderson, NV
  • NPI 1902864614
  NPD (past) Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234224000000",
    "number": "1962420455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891462976",
            "telephone_number": "702-876-0320",
            "fax_number": "702-876-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891462976",
            "telephone_number": "702-876-0320",
            "fax_number": "702-876-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN PETERSON O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-299-6200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506817",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508598",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY FOCUSED EYECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.