EASTLAKE VISION CLINIC PC (NPI# 1801071709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801071709 |
| Entity Type | Organization |
| Organization Name | EASTLAKE VISION CLINIC PC |
| Practice Address |
12450 York St Thornton CO 80241-2741 |
| Practice Telephone | 3034522020 |
| Practice Fax Number | 3034520934 |
| Mailing Telephone | 3034522020 |
| Mailing Fax Number | 3034520934 |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-02-05 |
| Authorized Official Name | DR. STANLEY R BLACK (PRESIDENT) |
| Authorized Official Telephone | 3034522020 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 830 | CO | Eye and Vision Services Providers |
| Street Address |
12450 YORK ST |
| City | THORNTON |
| State | CO |
| Zip Code | 80241-2741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851464366 | Stanley R Black | Optometrist | 12450 York St, Thornton, CO 80241-2741 | 2006-11-15 |
| 1154592228 | Colorado Eye Center, LLC | Optometrist | 12450 York St, Thornton, CO 80241-2741 | 2008-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437787991 | Melanie Tyler | Counselor | 12301 Pennsylvania, Suite 101, Thornton, CO 80241 | 2020-03-31 |
| 1487218699 | Diane Marie Hansen | Counselor | 491 E 133rd Way, Thornton, CO 80241 | 2019-04-24 |
| 1164979712 | James Brannan | Contractor | 13364 Birch Court, Thornton, CO 80241 | 2016-09-01 |
| 1083925200 | Keralee Vought | Social Worker | 12015 Grape St, Thornton, CO 80241 | 2010-06-23 |
| 1770767675 | Charles E Januschka | Chiropractor | 3953b E 120th Ave, Thornton, CO 80241 | 2007-12-27 |
| 1407928724 | Erica A Derby | Dentist | 2800 East 136th Avenue, Thornton, CO 80241 | 2006-11-14 |
| 1558445361 | Carolyn Watt Mauterer | Dentist | 2800 E 136th Ave, Thornton, CO 80241 | 2006-10-25 |
| 1215046842 | Adams 12 Five Star Schools | Local Education Agency (LEA) | 1500 E 128th Avenue, Adams 12 Five Star Schools C/o Sandra Sellstrom, Thornton, CO 80241 | 2006-08-29 |
| 1366932162 | University of Colorado Hospital Authority | Clinic/Center | 12020 Colorado Blvd, Thornton, CO 80241 | 2018-05-16 |
| 1376077438 | Spencer Del Moral | Student in an Organized Health Care Education/Training Program | 4075 E 128th Ave, Thornton, CO 80241 | 2017-04-16 |
| Find all providers in zip 80241 | ||||
| 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 |
|---|---|---|---|---|
| 1831796010 | Madison Street Provider Network Inc | Optometrist | 10001 N. Washington St., Thornton, CO 80229-2050 | 2020-10-01 |
| 1508334541 | Thornton Youth Vision, LLC | Optometrist | 9674 Washington St Unit 104, Thornton, CO 80229-2160 | 2018-11-07 |
| 1376906966 | Samantha Jean Winder | Optometrist | 550 Thornton Pkwy Unit 222, Thornton, CO 80229-2168 | 2016-03-31 |
| 1336573302 | Best Eyecare Associates, P.C. | Optometrist | 2750 E 136th Ave # 201, Thornton, CO 80241-3432 | 2013-08-27 |
| 1326360900 | Vista Eye Care, PC | Optometrist | 13695 Colorado Blvd, Thornton, CO 80602-7051 | 2010-02-23 |
| 1629390612 | One Hour Optical Medical Services, PC | Optometrist | 3867 E 120th Ave., Thornton, CO 80233-1660 | 2010-02-18 |
| 1851464366 | Stanley R Black | Optometrist | 12450 York St, Thornton, CO 80241-2741 | 2006-11-15 |
| 1740369248 | Stacy Lynn Hieb | Optometrist | 3867 E 120th Ave, Thornton, CO 80233-1660 | 2006-11-03 |
| 1801983598 | Eric H Broecker | Optometrist | Colorado Eye Center, 10001 N Washington, Thornton, CO 80229 | 2006-10-06 |
| 1497741151 | Richard M Goebel | Optometrist | 101 W 84th Ave, Ste 240, Thornton, CO 80260-4807 | 2005-09-27 |
| Find all providers in THORNTON | ||||
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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.