DR. TIMOTHY R LANDIS (NPI# 1578555645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578555645 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY R LANDIS |
| Credential | OD |
| Practice Address |
559 Vincent St Bldg 959 Peterson Afb CO 80914-1541 |
| Mailing Address |
1895 Nature Park Dr North Las Vegas NV 89084-3151 |
| Practice Telephone | 7026533010 |
| Practice Fax Number | 7026533023 |
| Mailing Telephone | 2703198784 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2018-03-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1322 DT | KY | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881258168 | Timothy Michael Landis | Student in an Organized Health Care Education/Training Program | 170 Manning Dr Cb# 7025, Chapel Hill, NC 27599-4220 | 2019-04-23 |
| 1972601425 | Timothy Donald Landis | Specialist | 5 Pine West Plz, Suite 510, Albany, NY 12205-5587 | 2006-09-20 |
| 1801819032 | Timothy Alan Landis | Social Worker | 518 28 Rd, Suite A207, Grand Junction, CO 81501-6556 | 2006-07-26 |
| Street Address |
559 VINCENT ST BLDG 959 |
| City | PETERSON AFB |
| State | CO |
| Zip Code | 80914-1541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649891557 | Ryan Barney | Social Worker | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2020-05-01 |
| 1871021444 | Danielle Markeeta Sales | Nurse Practitioner | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2017-05-26 |
| 1851827422 | Pablo Garcia | Physician Assistant | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2017-05-02 |
| 1497206510 | Suzanne Mirts | Registered Nurse | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2016-10-24 |
| 1760843437 | Matthew Jeffrey Parrish | Dentist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2016-03-09 |
| 1801261771 | Jennifer Dell Shoemake | Nurse Practitioner | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2015-12-03 |
| 1235531088 | Jaquelyn Suarez-murias | Physical Therapist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2014-09-24 |
| 1598179772 | Andrew Rhoads Glynn | Dentist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2014-06-17 |
| 1710306873 | Peter Edward Fosse | Pharmacist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2014-04-15 |
| 1720406796 | Beth D Achterhoff | Physical Therapist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914 | 2014-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356897250 | Kym Littlefield Whitaker | Nurse Practitioner | 110 Ent Avenue, Peterson Afb, CA 80914 | 2016-08-30 |
| 1114322583 | Jessica Charmaine Johnson | Social Worker | 559 Vincent St, Bldg 959, Attn: 21 Omrs/sgow, Peterson Afb, CO 80914 | 2014-10-28 |
| 1306916267 | John Frank Drozd | Psychologist | 21st Medical Group, 559 Vincent Street, Peterson Afb, CO 80914 | 2006-11-08 |
| 1801858865 | Moshe Mark Douglas Wexler | Clinical Neuropsychologist | 110 W. Ent Ave. Bldg 725, 21 Mdos/sgoh, Pafb, CO 80914 | 2006-04-05 |
| 1215902002 | William J Dickson | Dentist | Peterson Afb, Bld 950, Colorado Springs, CO 80914 | 2006-02-23 |
| 1740889773 | Brandon Dean Estes | Dental Hygienist | 1055 Stewart Ave, Bldg 2018, Apo, AA 80914 | 2020-10-21 |
| 1811378607 | Justin Henry Noble | Family Medicine | 559 Vincent St, Colorado Springs, CO 80914 | 2015-06-17 |
| 1225310162 | Zachary Edward Bishop | Pharmacist | 559 Vincent St, Attn: 21 Mdss/sgsap, Peterson Afb, CO 80914 | 2011-09-16 |
| 1659603256 | Thomas Wescott Mahoney | Family Medicine | 559 Vincent St, 21 Mdos/sgof Attn: Family Health, Peterson Afb, CO 80914 | 2010-02-05 |
| 1720210248 | Dewaine Allen Olson Jr. | Military Health Care Provider | 559 Vincent St, Peterson Afb, CO 80914 | 2009-08-17 |
| Find all providers in zip 80914 | ||||
| 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 |
|---|---|---|---|---|
| 1992791560 | Jeffrey A Newsom | Optometrist | 559 Vincent St Bldg 959, 21 Medical Group, Peterson Afb, CO 80914-1541 | 2005-09-20 |
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| 1780283564 | Eye Love Care Inc | Optometrist | 1455 S Chelton Rd, Colorado Springs, CO 80910-1663 | 2020-10-22 |
| 1154929602 | Madison Street Provider Network, LLC | Optometrist | 125 Inverness Dr E Ste 200, Englewood, CO 80112-5138 | 2020-10-15 |
| 1124626015 | Ekin Vision Care LLC | Optometrist | 1 W Flatiron Crossing Dr Ste 1104, Broomfield, CO 80021-8886 | 2020-10-13 |
| 1538766654 | Sky High Vision | Optometrist | 14749 W 87th Pkwy, Unit D, Arvada, CO 80005 | 2020-10-01 |
| 1033716212 | Madison Street Provider Network Inc | Optometrist | 1371 Hecla Dr Ste C, Louisville, CO 80027-2318 | 2020-10-01 |
| 1831796010 | Madison Street Provider Network Inc | Optometrist | 10001 N. Washington St., Thornton, CO 80229-2050 | 2020-10-01 |
| 1154928331 | Madison Street Provider Network Inc | Optometrist | 4103 Boardwalk Dr Unit 100, Fort Collins, CO 80525-5933 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | PETERSON AFB |
| Zip Code | 80914 |
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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.