MEDICARE: NATIONAL VISION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1538933411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL VISION INC

Provider Business Mailing Address
First Line	:	2435 COMMERCE AVE BLDG 2200
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-4980
Country	:	US
Telephone Number	:	678-892-3760
Fax Number	:

Provider Business Practice Location Address
First Line	:	3625 MIDWAY DR STE P
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-5253
Country	:	US
Telephone Number	:	619-321-4681
Fax Number	:

Authorized Official
Title or Position	:	MGD CARE SALES
Name	:	LEAHANN RENE VAUGHN
Credential	:
Telephone Number	:	470-448-2782

Provider Enumeration Date	:	11/10/2023
Last Update Date	:	05/09/2025

Similar Medicare Providers

1578876447 — DR. EFREM JONATHAN PRADO O.D.
Practice Location Address:

3625 MIDWAY DR , STE P
SAN DIEGO, CA
92110-5253

Practice Phone: 619-223-3028
Practice Fax: 619-223-3042

1659752137 — AJAY D AMIN DDS
Practice Location Address:

3625 MIDWAY DR STE A
SAN DIEGO, CA
92110-5253

Practice Phone: 619-224-2204
Practice Fax:

1093169476 — NATIONAL VISION, INC.
Practice Location Address:

3625 MIDWAY DR , SUITE P
SAN DIEGO, CA
92110-5253

Practice Phone: 619-321-4681
Practice Fax: 619-221-2990

1801341847 — LARRY A WOZNUK DDS INC
Practice Location Address:

3625 MIDWAY DR , STE A
SAN DIEGO, CA
92110-5253

Practice Phone: 619-224-2204
Practice Fax:

1275003048 — AJAY D. AMIN D.D.S. INC.
Practice Location Address:

3625 MIDWAY DR STE A
SAN DIEGO, CA
92110-5253

Practice Phone: 619-224-2204
Practice Fax:

1992432033 — REGENCY EYE CARE, INC.
Practice Location Address:

3625 MIDWAY DR
SAN DIEGO, CA
92110-5253

Practice Phone: 619-321-4681
Practice Fax: 619-221-2990

Directions to “NATIONAL VISION INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.