VISTA OPTICAL (NPI# 1295188050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295188050 |
| Entity Type | Organization |
| Organization Name | VISTA OPTICAL |
| Practice Address |
102 W Octagon St Bldg 77b Cannon Afb NM 88103-5207 |
| Mailing Address |
2435 Commerce Ave Bldg 2200 Duluth GA 30096-4980 |
| Practice Telephone | 5759041001 |
| Practice Fax Number | 5757849722 |
| Mailing Telephone | 7708223600 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |
| Authorized Official Name | LISA AULTMAN (MANAGED CARE COORDINATOR) |
| Authorized Official Telephone | 7708224203 |
| Is Organization Subpart | Y |
| Parent Organization Name | NATIONAL VISION, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609997972 | Vista Optical | Technician/Technologist | 2333 N Triphammer Rd Ste 403, Ithaca, NY 14850-1075 | 2007-04-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | VISTA OPTICAL | 2435 Commerce Avenue, Building 2200, Duluth, GA 30096 |
| Colorado Business Entities | VISTA OPTICAL, INC. | 704 West Southern Ave, Fullerton, CA 92835 |
| Street Address |
102 W OCTAGON ST BLDG 77B |
| City | CANNON AFB |
| State | NM |
| Zip Code | 88103-5207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346747151 | Isabella Wolak | Pharmacist | 224 D L Ingram Blvd, Cannon Afb, NM 88103 | 2018-04-09 |
| 1225480544 | Stacey Tatro | Dentist | 224 West D.l. Ingram Ave., Bldg 1408, Cannon Afb, NM 88103 | 2016-07-11 |
| 1871965673 | Chad Bryan Carter | Dentist | 224 W Dl Ingram Ave, Sgpd/dental Clinic, Cannon Air Force Base, NM 88103 | 2015-10-20 |
| 1740660836 | Terah Clifford | Dental Hygienist | 224 W Dl Ingram Blvd, Bldg 1408 Dental Clinic, Cannon Afb, NM 88103 | 2015-06-03 |
| 1528452208 | Taylor Bottari | Physician Assistant | 208 W Dl Ingram, Cannon Afb, NM 88103 | 2015-03-20 |
| 1588071328 | Gretchen Evelynn Szymanski | Nurse Practitioner | Cannon Afb, 224 W D.l. Ingram Blvd, Cannon Afb, NM 88103 | 2014-07-14 |
| 1396155206 | Jennifer Brynn Bendokas | Physician Assistant | 224 West Dl Ingram Avenue, Cannon Afb, NM 88103 | 2014-04-30 |
| 1366889487 | Jeremy Michael Strohmayer | General Practice | 511 Chindt Blvd Building 300, 27soss/osm, Cannon Afb, NM 88103 | 2013-05-30 |
| 1356622401 | Matthew John Nielsen | Dentist | 224 W D.l. Ingram, Bld. 1408, Cannon Afb, NM 88103 | 2011-09-02 |
| 1689965485 | Bryan Wade Sixkiller | Optometrist | 27th Somdg, 208 W. Casa Blanca Ave., Apo, AA 88103 | 2011-04-27 |
| Find all providers in zip 88103 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477187912 | Jacqueline Rodriguez | Technician/Technologist | 1110 Vuelta De Las Acequias, Santa Fe, NM 87507-7105 | 2020-02-24 |
| 1275056186 | Marie Angela Archibeque | Technician/Technologist | 2910 San Mateo Blvd Ne Ste 6, Albuquerque, NM 87110-3187 | 2017-07-23 |
| 1558882910 | Norma Karram | Technician/Technologist | 1300 W Maloney Ave Ste 208, Gallup, NM 87301-3325 | 2017-07-06 |
| 1649619511 | National Vision Optical | Technician/Technologist | 7901 Gibson Blvd, Bldg 20176, Kirtland, NM 87117 | 2013-06-24 |
| 1437403359 | National Vision Optical | Technician/Technologist | Main Exchange Bldg. 260, White Sands Missile Range, NM 88002 | 2012-10-30 |
| 1548541204 | Roberta Jean Montoya I | Technician/Technologist | 3905 Isleta Blvd Sw, Albuquerque, NM 87105-6130 | 2011-09-07 |
| 1144534892 | Kathryn Branch Casey | Technician/Technologist | 1101 State Road 1, Socorro, NM 87801-5004 | 2010-08-04 |
| 1629396015 | Lorraine Gomez | Technician/Technologist | 4201 Central Ave Ne, #b2, Albuquerque, NM 87105-1630 | 2010-05-10 |
| 1043534209 | Ray J Montoya | Technician/Technologist | 1908 N Prince St, Clovis, NM 88101-4857 | 2010-03-17 |
| 1609019405 | Brian K Boddy | Technician/Technologist | 3530 Zafarano Dr Ste C1, Santa Fe, NM 87507-2609 | 2009-04-09 |
| Find all providers with the same taxonomy | ||||
| City | CANNON AFB |
| Zip Code | 88103 |
Please comment or provide details below to improve the information on VISTA OPTICAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.