WISCONSIN VISION, INC


Address: 3972 W Jefferson Blvd, Fort Wayne, IN 46804-6812
Phone: 2604341998

WISCONSIN VISION, INC (NPI# 1639217730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1639217730
Entity Type Organization
Organization Name WISCONSIN VISION, INC
Other Organization Name HEARTLAND VISION
Practice Address 3972 W Jefferson Blvd
Fort Wayne
IN 46804-6812
Mailing Address 16800 West Cleveland Ave
New Berlin
WI 53151-3533
Practice Telephone 2604341998
Practice Fax Number 2604366455
Mailing Telephone 2624322005
Mailing Fax Number 2624322006
Enumeration Date 2007-02-01
Last Update Date 2015-11-30
Authorized Official Name MR. DARREN THOMAS HORNDASCH (PRESIDENT CEO)
Authorized Official Telephone 2624322005
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 156FX1800X Technician/Technologist
Specialization: Optician
Eye and Vision Services Providers

Other Provider Identifier

State Issuer Identifier Type Code
DAVIS VISION PROVIDER NO. 58256 01
SPECTERA PROVIDER NO, 02855 01

Other Provider/Organization Names

Other Name Type Code
Heartland Vision Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1568654333 Wisconsin Vision, Inc Technician/Technologist 6035 Durand Ave, Racine, WI 53406-5049 2007-08-15
1871631978 Wisconsin Vision, Inc Technician/Technologist 2030 S Reed Rd, Kokomo, IN 46902-1905 2007-02-01
1548308745 Wisconsin Vision, Inc Technician/Technologist 2929 Milton Ave, Janesville, WI 53545-0253 2007-02-01
1588702781 Wisconsin Vision, Inc Technician/Technologist 1510 S Koeller St, Oshkosh, WI 54902-6167 2007-02-01
1770621971 Wisconsin Vision, Inc Technician/Technologist 351 N Casaloma Dr, Appleton, WI 54913-9101 2007-02-01
1538207717 Wisconsin Vision, Inc Technician/Technologist 7528 W Burleigh St, Milwaukee, WI 53210-1030 2007-02-01
1235277427 Wisconsin Vision, Inc Technician/Technologist 4818 S 76th St Ste 1, Greenfield, WI 53220-4362 2007-02-01
1518005719 Wisconsin Vision, Inc Technician/Technologist 2612 E Washington Ave, Madison, WI 53704-5026 2007-02-01
1497893598 Wisconsin Vision, Inc Technician/Technologist 280 N Phelps Ave Unit A, Rockford, IL 61108-2498 2007-02-01
1427561166 Wisconsin Vision, Inc Optometrist 358 S Koeller St, Oshkosh, WI 54902-5546 2017-11-15

Other Data Sources

Entity Type Entity Name Entity Address
Indiana Business Entities WISCONSIN VISION, INC. 16800 W. Cleveland Ave, New Berlin, WI 53151

Office Location

Street Address 3972 W JEFFERSON BLVD
City FORT WAYNE
State IN
Zip Code 46804-6812

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396350344 Derek Mumaw Physical Therapist 8420 Illinois Rd, Fort Wayne, IN 46804 2020-09-15
1942840228 Erin M Mason Behavior Technician 5601 Coventry Ln, Fort Wayne, IN 46804 2020-01-14
1346880879 Emily A Abdalla Behavior Technician 5601 Coventry Ln., Fort Wayne, IN 46804 2020-01-13
1083265433 Fort Wayne Endodontics Dentist 9407 Illinois Rd, Fort Wayne, IN 46804 2019-09-26
1689140949 Harrison Dental Group II, LLC Dentist 1333 Getz Rd, Fort Wayne, IN 46804 2018-10-15
1346731908 Erin Nicole Zimmerman Nurse Practitioner 10170 Illinois Rd # 14, Fort Wayne, IN 46804 2018-05-19
1417446022 Mary Harrington Physical Therapist 3320 Copper Hill Run, Fort Wayne, IN 46804 2018-05-09
1942701214 Joshawa Todd Torres Marriage & Family Therapist 5651 Coventry Ln # 116, Fort Wayne, IN 46804 2018-02-22
1194235408 Mitchell Kory Meyer Specialist/Technologist 9125 Yellow Tree Ct, Fort Wayne, IN 46804 2017-10-02
1902324916 Emily Rene Sagstetter Specialist/Technologist 6034 Liberty Glade Ct, Fort Wayne, IN 46804 2017-08-30
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Taxonomy Information

Taxonomy Code 156FX1800X
Grouping Eye and Vision Services Providers
Classification Technician/Technologist
Specialization Optician

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1326283615 America's Best Contacts & Eyeglasses Technician/Technologist 10021 Lima Rd, Fort Wayne, IN 46818-8904 2008-12-16
1851473086 Wal-mart Stores East, Lp Technician/Technologist 5311 Coldwater Rd, Fort Wayne, IN 46825-5444 2006-10-19
1639250053 Vision Care Associates PC Technician/Technologist 7750 W Jefferson Blvd, Fort Wayne, IN 46804-4174 2006-10-19
1871675017 Wal-mart Stores East, Lp Technician/Technologist 1710 Apple Glen Blvd, Fort Wayne, IN 46804-1725 2006-10-19
1275615189 Wal-mart Stores East, Lp Technician/Technologist 10420 Maysville Rd, Fort Wayne, IN 46835-9762 2006-10-19
1861581662 Sam's Club Optical Technician/Technologist 6736 Lima Rd, Fort Wayne, IN 46818-1118 2006-10-12
1073613337 Wal-mart Stores East, Lp Technician/Technologist 7502 Southtown Xing, Fort Wayne, IN 46816-2515 2006-09-25

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1700323508 National Vision, Inc. Technician/Technologist 171 Us 41, Schererville, IN 46375 2017-01-31
1033575824 National Vision, Inc. Technician/Technologist 16787 Clover Rd, Noblesville, IN 46060-3646 2016-01-08
1346664745 Phillip Thomas Technician/Technologist 102 Hillside Cir, Charlestown, IN 47111-1007 2014-02-06
1750627782 Kenneth Wayne Mckeand Technician/Technologist 1401 E Center St, Warsaw, IN 46580-3525 2012-12-19
1114277597 Sams East Inc Technician/Technologist 3819 State Road 26 E, Lafayette, IN 47905-4872 2012-09-13
1821372665 Jedeye LLC Technician/Technologist 2005 Diplomat Ln, Kokomo, IN 46902-3298 2011-09-28
1457650335 Brownell Norman Payne Jr. Technician/Technologist 1537 Greer Dell Rd, Indianapolis, IN 46260-4427 2011-03-18
1215245816 Wal-mart Stores East Lp Technician/Technologist 240 Mall Road, Logansport, IN 46947 2010-09-16
1750607909 Eyes 2020 Inc. Technician/Technologist 3757 E Main St, Richmond, IN 47374-3614 2010-04-13
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City FORT WAYNE
Zip Code 46804

Improve Information

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Dataset Information

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.

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