MAVENCAMP FAMILY EYECARE, INC (NPI# 1922205061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922205061 |
| Entity Type | Organization |
| Organization Name | MAVENCAMP FAMILY EYECARE, INC |
| Practice Address |
570 Riverstone Way Suite 3 Fairbanks AK 99709-2939 |
| Practice Telephone | 9074794700 |
| Practice Fax Number | 9074575596 |
| Mailing Telephone | 9074794700 |
| Mailing Fax Number | 9074575596 |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2014-01-02 |
| Authorized Official Name | DR. MICHAEL MAVENCAMP (PRESIDENT) |
| Authorized Official Telephone | 9074794700 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | A240 | AK | Eye and Vision Services Providers |
| Street Address |
570 RIVERSTONE WAY SUITE 3 |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99709-2939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235298134 | Barbara M Keys | Optometrist | 570 Riverstone Way, Ste 3, Fairbanks, AK 99709 | 2006-12-06 |
| 1114534179 | Donna Renee Coben-hall | Massage Therapist | 570 Riverstone Way, Fairbanks, AK 99709-2940 | 2020-09-24 |
| 1073081485 | Tanana Valley Clinic LLC | Clinic/Center | 570 Riverstone Way, Fairbanks, AK 99709-2940 | 2018-11-05 |
| 1073046983 | Karlan Bachmann | Massage Therapist | 570 Riverstone Way, Fairbanks, AK 99709 | 2017-04-07 |
| 1023410529 | Henry Charles Jensen | Dentist | 570 Riverstone Way, Suite 1, Fairbanks, AK 99709-2940 | 2014-09-16 |
| 1588800817 | Colleen Personett, Od, LLC | Optometrist | 570 Riverstone Way, Suite 3, Fairbanks, AK 99709-2939 | 2008-12-16 |
| 1760653778 | Ruth Nicolas, Od, PC | Optometrist | 570 Riverstone Way, Ste 3, Fairbanks, AK 99709-2939 | 2008-03-18 |
| 1477686467 | Norman Todd Lovell | Chiropractor | 570 Riverstone Way, Suite #2, Fairbanks, AK 99709-2939 | 2007-03-13 |
| 1760541676 | Michael J Mavencamp | Optometrist | 570 Riverstone Way, Ste 3, Fairbanks, AK 99709 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
| 1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
| 1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
| 1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
| 1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
| 1255652285 | Surgery Center of Fairbanks LLC | Clinic/Center | 2310 Peger Road, Fairbanks, AK 99709 | 2010-06-14 |
| 1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
| 1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
| Find all providers in zip 99709 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396947297 | Virginia R. Lind | Optometrist | 59 College Rd Ste 209, Fairbanks, AK 99701-1757 | 2007-06-03 |
| 1235354515 | West Valley Vision Center, Inc | Optometrist | 4169 Geist Rd, Fairbanks, AK 99709-3420 | 2007-04-13 |
| 1235252073 | W. Henry Macpherson | Optometrist | 537 Johansen Expressway, Walmart Vision Center, Fairbanks, AK 99701 | 2007-04-09 |
| 1093874182 | Augusta Ann Plassmann King | Optometrist | 1521 Stacia St, Unit B, Fairbanks, AK 99701-6135 | 2006-12-06 |
| 1235298134 | Barbara M Keys | Optometrist | 570 Riverstone Way, Ste 3, Fairbanks, AK 99709 | 2006-12-06 |
| 1558453753 | Virginia R Lind & Ronald L Lind Lind Virginia R Gen Ptr | Optometrist | 59 College Road, Suite 209, Fairbanks, AK 99701-1757 | 2006-09-28 |
| 1114935616 | Anita Mullins | Optometrist | 201 Old Steese Hwy Ste 2, Fairbanks, AK 99701-3160 | 2006-08-03 |
| 1568478782 | William Matthew Riley | Optometrist | 1867 Airport Way Ste 150a, Fairbanks, AK 99701-4061 | 2006-07-31 |
| 1164411930 | David James Peterson | Optometrist | 116 Minnie St, Fairbanks, AK 99701-3006 | 2005-10-14 |
| 1841807062 | Terry David Bell | Optometrist | 116 Minnie St, Fairbanks, AK 99701-3006 | 2020-10-01 |
| Find all providers in FAIRBANKS | ||||
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| 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.