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).
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 |
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 |
---|---|---|---|
DAVIS VISION PROVIDER NO. | 58256 | 01 | |
SPECTERA PROVIDER NO, | 02855 | 01 |
Other Name | Type Code |
---|---|
Heartland Vision | Doing Business As Name - Organization |
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 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Indiana Business Entities | WISCONSIN VISION, INC. | 16800 W. Cleveland Ave, New Berlin, WI 53151 |
Street Address |
3972 W JEFFERSON BLVD |
City | FORT WAYNE |
State | IN |
Zip Code | 46804-6812 |
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 |
Find all providers in zip 46804 |
Taxonomy Code | 156FX1800X |
Grouping | Eye and Vision Services Providers |
Classification | Technician/Technologist |
Specialization | Optician |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659619427 | Usv Optical Inc. | Technician/Technologist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2013-01-29 |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689210296 | Vision Mart Eye Center, Inc. | Technician/Technologist | 4684 S Us Hwy 41, Terre Haute, IN 47802-5404 | 2019-11-19 |
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 |
Find all providers with the same taxonomy |
City | FORT WAYNE |
Zip Code | 46804 |
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.