WISCONSIN VISION, INC. (NPI# 1558409656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558409656 |
| Entity Type | Organization |
| Organization Name | WISCONSIN VISION, INC. |
| Practice Address |
2158 W Mason St Green Bay WI 54303-4705 |
| Mailing Address |
16800 West Cleveland Ave New Berlin WI 53151-3533 |
| Practice Telephone | 9204909860 |
| Practice Fax Number | 9204909861 |
| Mailing Telephone | 2624322005 |
| Mailing Fax Number | 2624322006 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2008-05-22 |
| Authorized Official Name | MR. DARREN THOMAS HORNDASCH (PRESIDENT CEO) |
| Authorized Official Telephone | 2624322005 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SPECTERA PROVIDER NO. | 09309 | 01 | |
| DAVIS VISION PROVIDER NO. | 56268 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457890220 | Wisconsin Vision, Inc. | Optometrist | 285 Market St., Suite E-107, Brookfield, WI 53045-3208 | 2017-02-14 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1295072544 | Wisconsin Vision, Inc. | Optometrist | 1220 Miller Park Way, West Milwaukee, WI 53214 | 2013-01-07 |
| 1023324811 | Wisconsin Vision, Inc. | Optometrist | 5530 N Port Washington Rd Unit C, Glendale, WI 53217-4920 | 2010-08-31 |
| 1811029234 | Wisconsin Vision, Inc. | Technician/Technologist | 2005 Silvernail Road, Pewaukee, WI 53072 | 2007-03-12 |
| 1801934807 | Wisconsin Vision, Inc. | Technician/Technologist | 203a Sunset Drive, Waukesha, WI 53189 | 2007-02-02 |
| 1477691673 | Wisconsin Vision, Inc. | Technician/Technologist | 5725 75th St, Kenosha, WI 53142-3603 | 2007-02-01 |
| 1447398649 | Wisconsin Vision, Inc. | Technician/Technologist | 5505 Odana Rd, Madison, WI 53719-1205 | 2007-02-01 |
| 1962540120 | Wisconsin Vision, Inc. | Technician/Technologist | 12876 W Bluemound Rd, Elm Grove, WI 53122-2605 | 2007-02-01 |
| 1134179427 | Wisconsin Vision, Inc. | Optometrist | 16800 W Cleveland Ave, New Berlin, WI 53151-3533 | 2006-05-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | WISCONSIN VISION, INC. | 16800 W. Cleveland Ave, New Berlin, WI 53151 |
| Street Address |
2158 W MASON ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-4705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336106939 | Michelle Gustin | Optometrist | 2158 W Mason St, Green Bay, WI 54303-4705 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528033 | Cheryl M Robertson | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2019-06-25 |
| 1962063495 | Christina L Reek | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2019-06-25 |
| 1073994133 | Kim Tavener | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2015-06-15 |
| 1700202538 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1499 W Mason St, Green Bay, WI 54303-2233 | 2014-03-18 |
| 1346525573 | Vision Mart, Inc | Technician/Technologist | 2476 S Oneida St, Suite 105, Green Bay, WI 54304-5289 | 2011-10-19 |
| 1770756397 | Judy Winney | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2008-04-03 |
| 1962675587 | Karen Vandenhouten | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2008-04-03 |
| 1386727501 | Wal-mart Stores East, Lp | Technician/Technologist | 2440 W Mason St, Green Bay, WI 54303-4711 | 2006-10-23 |
| 1184707309 | Wal-mart Stores East, Lp | Technician/Technologist | 2292 Main St, Green Bay, WI 54311-5307 | 2006-10-23 |
| 1033214275 | Sam's Club Optical | Technician/Technologist | 2470 W Mason St, Green Bay, WI 54303-4711 | 2006-09-13 |
| Find all providers in GREEN BAY | ||||
Please comment or provide details below to improve the information on WISCONSIN VISION, INC..
| 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.