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1598067902 NPI number — INNOVATIVE VISION CARE, LLC

NPI Number: 1598067902
Health Care Provider/Practitioner: INNOVATIVE VISION CARE, LLC

Information about “1598067902” NPI (INNOVATIVE VISION CARE, LLC) exists in 1598067902 in HTML format HTML  |  1598067902 in plain Text format TXT  |  1598067902 in PDF (Portable Document Format) PDF  |  1598067902 in an XML format XML  formats.

NPI Number : 1598067902 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1598067902",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "INNOVATIVE VISION CARE, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "101 APPLE VALLEY PKWY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BELTON",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "64012-4725",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "816-331-9590",
    "MailingAddressFaxNumber": "816-368-9281",
    "FirstLinePracticeLocationAddress": "101 APPLE VALLEY PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BELTON",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "64012-4725",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "816-331-9590",
    "PracticeLocationAddressFaxNumber": "816-368-9281",
    "EnumerationDate": "11/18/2010",
    "LastUpdateDate": "12/15/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LAW",
    "AuthorizedOfficialFirstName": "AARON",
    "AuthorizedOfficialMiddleName": "S",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "O.D.",
    "AuthorizedOfficialTelephoneNumber": "816-331-9590",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "152W00000X",
        "TaxonomyName": "Optometrist",
        "LicenseNumber": "2008017076",
        "LicenseNumberStateCode": "MO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X 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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