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1184821126 NPI number — YOUR CHILDS EYES LLC

NPI Number: 1184821126
Health Care Provider/Practitioner: YOUR CHILDS EYES LLC

Information about “1184821126” NPI (YOUR CHILDS EYES LLC) exists in 1184821126 in HTML format HTML  |  1184821126 in plain Text format TXT  |  1184821126 in PDF (Portable Document Format) PDF  |  1184821126 in an XML format XML  formats.

NPI Number : 1184821126 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184821126",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "YOUR CHILDS EYES LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2221 E BIJOU ST.",
    "SecondLineMailingAddress": "STE. 100",
    "MailingAddressCityName": "COLORADO SPRINGS",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80909",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "719-329-1221",
    "MailingAddressFaxNumber": "719-329-1511",
    "FirstLinePracticeLocationAddress": "2857 E FOUNTAIN BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLORADO SPRINGS",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80910-2312",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "719-329-1221",
    "PracticeLocationAddressFaxNumber": "719-329-1511",
    "EnumerationDate": "07/02/2007",
    "LastUpdateDate": "11/23/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LEBLANC",
    "AuthorizedOfficialFirstName": "SAMANTHA",
    "AuthorizedOfficialMiddleName": "B",
    "AuthorizedOfficialTitle": "CREDENTIALING SPECIALIST",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "719-323-2372",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": "1462",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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