BALLANTYNE VISION CARE LLC — NPI 1306146121 (Licensed & Credentialed Eye and Vision Service Providers

CMS-1500 Box 24J / 33a • NPI

1306146121

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

152W00000X (CMS 41)

Licensed & Credentialed Eye and Vision Service Providers — Optometrist

Box 32 Service Location & ZIP+4

302 W 3RD ST, LA JUNTA, CO, 81050-1430

✓ 9-Digit EDI 837 ZIP+4 (81050-1430)

Practice Phone & Referral Fax

(719) 383-0134

Fax: (719) 404-1825

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1306146121 (BALLANTYNE VISION CARE LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1306146121` (NPI-2 Organization / Facility)
Provider / Legal Name	BALLANTYNE VISION CARE LLC
Plain-English Specialty	Licensed & Credentialed Eye and Vision Service Providers — Optometrist NUCC Code: `152W00000X` (Optometrist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	302 W 3RD ST, LA JUNTA, CO, 81050-1430
Practice Telephone / Fax	Tel: (719) 383-0134 \| Fax: (719) 404-1825
Administrative Mailing Address	PO BOX 305, LA JUNTA, CO, 81050-0305
Enumeration & Last Sync	Enumerated: 2010-10-26 \| CMS Record Updated: 2016-10-10
Authorized Official	JORDAN BALLANTYNE (Optometrist, Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

302 W 3RD ST, LA JUNTA, CO, 81050-1430

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Plain-English Taxonomy & CMS Crosswalk (152W00000X)

What Does Taxonomy Code 152W00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 152W00000X translates to:
"Licensed & Credentialed Eye and Vision Service Providers — Optometrist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 41 (Optometry)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Optometrist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BALLANTYNE VISION CARE LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`152W00000X` — Optometrist Plain English: Licensed & Credentialed Eye and Vision Service Providers — Optometrist	State: CO \| License: `2799` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BALLANTYNE VISION CARE LLC (NPI #1306146121)