NPIMap

Organization Active NPI

SVS Vision Inc

  • Optometrist
  • Marysville, MI
National Provider Identifier
1003941055
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SVS VISION INC
Practice address
3184 Gratiot Blvd
Marysville, MI 48040-1488
Phone
(810) 364-5520
Fax
(810) 364-6545
NPI assigned
Feb 22, 2007
Last updated
Jun 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert G Farrell Jr., OD
Title
Owner/Ceo
Phone
(586) 468-7370

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X MI
Optometrist 152W00000X Primary

Addresses

Primary practice location

3184 Gratiot Blvd
Marysville, MI 48040-1488

Mailing address

118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 464-1479

Other identifiers 1

IdentifierTypeStateIssuer
4796222MedicaidMI

Other names 1

  • SVS VISION 07 Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090427000507 MI Part B Supplier - Clinic/Group Practice 9931257110 Receives reassigned benefits from 109 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
SVS Vision Inc64 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1003941055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432204",
            "telephone_number": "586-464-1479",
            "fax_number": "586-464-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3184 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480401488",
            "telephone_number": "810-364-5520",
            "fax_number": "810-364-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SVS VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "586-468-7370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4796222",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SVS VISION 07",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SVS VISION 07",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marysville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.