NICOLEX LLC (NPI# 1003221185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003221185 |
| Entity Type | Organization |
| Organization Name | NICOLEX LLC |
| Other Organization Name | MOON VALLEY EYECARE |
| Practice Address |
14435 N 7th St Ste 104 Phoenix AZ 85022-4371 |
| Practice Telephone | 6029932727 |
| Practice Fax Number | 6024490681 |
| Mailing Telephone | 6029932727 |
| Mailing Fax Number | 6024490681 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2015-03-13 |
| Authorized Official Name | DR. JESSE VINCENT DOMINGUEZ (PRESIDENT) |
| Authorized Official Telephone | 6233308723 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | AZ1210 | AZ | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 747561 | 05 |
| Other Name | Type Code |
|---|---|
| Moon Valley Eyecare | Doing Business As Name - Organization |
| Street Address |
14435 N 7TH ST STE 104 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85022-4371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649452418 | Monette Atchley | Registered Nurse | 14435 N 7th St, Suite 300a, Phoenix, AZ 85022-4371 | 2007-12-03 |
| 1295103406 | Monette Atchley, LLC | Acupuncturist | 14435 N 7th St, Suite 300a, Phoenix, AZ 85022-4371 | 2015-09-03 |
| 1124322557 | Marcia Francy Weiman | Specialist/Technologist | 14435 N 7th St, Suite 300, Phoenix, AZ 85022-4371 | 2010-12-28 |
| 1508170606 | Andrea Dawn Matson | Specialist/Technologist | 14435 N 7th St, Suite 300, Phoenix, AZ 85022-4371 | 2010-07-30 |
| 1073824405 | Alex J Barrus | Specialist/Technologist | 14435 N 7th St, Phoenix, AZ 85022-4371 | 2010-06-30 |
| 1164743670 | Patricia Ellen Schachtner | Specialist/Technologist | 14435 N 7th St, Suite 300, Phoenix, AZ 85022-4371 | 2010-06-18 |
| 1790014322 | Amy Marie Phelps | Specialist/Technologist | 14435 N 7th St, Phoenix, AZ 85022-4371 | 2009-12-10 |
| 1346481918 | Kid Talk & Play LLC | Clinic/Center | 14435 N 7th St, Suite 300 & 204, Phoenix, AZ 85022-4371 | 2009-03-11 |
| 1689826562 | Lauren Elizabeth Cashel | Occupational Therapist | 14435 N 7th St, Suite 300, Phoenix, AZ 85022-4371 | 2008-10-22 |
| 1609059575 | Melissa Snowden Smith | Speech-Language Pathologist | 14435 N 7th St, Phoenix, AZ 85022-4371 | 2007-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528626074 | Keauna Olugu | Psychologist | 17249 N. 7th St, 1128, Phoenix, AZ 85022 | 2019-05-30 |
| 1215455498 | Kristi Etchechury | Occupational Therapy Assistant | 807 East Beck Lane, Phoenix, AZ 85022 | 2017-09-07 |
| 1871017103 | Julie Dale | Physical Therapist | 1910 E Kathleen Rd, Phoenix, AZ 85022 | 2017-07-28 |
| 1669994539 | Valley Wellness Center Pllc | Clinic/Center | 702 E Bell Rd Ste 112, Phoenix, AZ 85022 | 2017-07-12 |
| 1386001758 | Debbie Mulder | Behavioral Analyst | 2400 West Dunlap Ave., Suite 100, Glendale, AZ 85022 | 2016-01-15 |
| 1114383437 | Jean Fay King | Nurse Practitioner | 15409 N. 23rd St., Phoenix, AZ 85022 | 2016-01-04 |
| 1093050767 | Cheyanne Wilderness Gastelum | Midwife | 2236 E. Delgado St., Phoenix, AZ 85022 | 2012-12-06 |
| 1760731236 | Nicole Ann Raus | Occupational Therapy Assistant | 15414 N. 7th Street, Suite 3, Phoenix, AZ 85022 | 2012-08-30 |
| 1144593211 | Edward Najeeb Abraham | Family Medicine | 14419 N. 5th Place, Phoenix, AZ 85022 | 2012-02-20 |
| 1942506019 | Mirnes Mehic | Assisted Living Facility | 2018 E. Wagoner Rd., Phoenix, AZ 85022 | 2011-02-07 |
| Find all providers in zip 85022 | ||||
| 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 |
|---|---|---|---|---|
| 1689283830 | Kelsie Stevens | Optometrist | 6815 N 19th Ave Ste 130, Phoenix, AZ 85015-1135 | 2020-07-23 |
| 1134747801 | National Vision Inc | Optometrist | 1838 W Bell Rd, Phoenix, AZ 85023-3480 | 2020-07-09 |
| 1770109282 | Nathan Jones | Optometrist | 6135 N 35th Ave Ste 139, Phoenix, AZ 85017-1953 | 2020-06-20 |
| 1447874755 | Jenna Derubeis | Optometrist | 16515 S 40th St Ste 111, Phoenix, AZ 85048-0559 | 2020-06-02 |
| 1184250383 | Jhajaira Elizabeth Cadenas | Optometrist | 3937 W Northview Ave, Phoenix, AZ 85051 | 2020-03-19 |
| 1659927663 | National Vision Inc | Optometrist | 2805 W Agua Fria Fwy Ste 1, Phoenix, AZ 85027-3940 | 2019-08-15 |
| 1588148993 | Jillian Ralston | Optometrist | 112 W Mcdowell Road, Phoenix, AZ 85003 | 2018-09-20 |
| 1932680618 | Carefree Eyecare | Optometrist | 3170 W Carefree Hwy Ste C3c4, Phoenix, AZ 85086-3205 | 2018-08-22 |
| 1710464417 | Ngoc Le | Optometrist | 1650 E Camelback Rd Ste 160, Phoenix, AZ 85016-3947 | 2018-07-25 |
| 1255826681 | Eric Bradford Vanausdal | Optometrist | 15215 S 48th St Ste 180, Phoenix, AZ 85044-9140 | 2018-06-27 |
| Find all providers in PHOENIX | ||||
Please comment or provide details below to improve the information on NICOLEX LLC.
| 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.