Family Vision Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FAMILY VISION CLINIC LLC

Practice address

110 Main St N
Elgin, ND 58533

Phone

(701) 584-3727

Fax

(701) 584-3727

NPI assigned

Sep 13, 2006

Last updated

Sep 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Krista Renae Heil, ODNPI 1215991799

Title

Owner

Phone

(701) 333-8243

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Family Vision Clinic LLC

  • Optometrist
  • Bismarck, ND
  • NPI 1235249475

  7618936659

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Family Vision Clinic LLC

  • Optometrist
  • Bismarck, ND
  • NPI 1235249475

  O20041006000613

  Same enrollment
• Family Vision Clinic LLP

  • Optometrist
  • Wilton, ND
  • NPI 1922103233

  O20041006000613

  Same enrollment

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Krista Renae Heil, O.D.

  • Optometrist
  • Bismarck, ND
  • NPI 1215991799
  Medicare reassignment Care Compare group NPD Authorized official
• Tyler Charles Clairmont

  • Optometrist
  • Bismarck, ND
  • NPI 1508585860
  Medicare reassignment Care Compare group NPD
• Amy Marie Fleck, OD

  • Optometrist
  • Bismarck, ND
  • NPI 1598712515
  Medicare reassignment NPD
• Wesley Schwartz, OD

  • Optometrist
  • Bismarck, ND
  • NPI 1588949630
  NPD

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1013012327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MAIN ST N",
            "city": "ELGIN",
            "state": "ND",
            "postal_code": "58533",
            "telephone_number": "701-584-3727",
            "fax_number": "701-584-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN ST N",
            "city": "ELGIN",
            "state": "ND",
            "postal_code": "58533",
            "telephone_number": "701-584-3727",
            "fax_number": "701-584-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY VISION CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "HEIL",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_middle_name": "RENAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-333-8243",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "530",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455794",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Aune, FNP-C
• Dakota Hill Housing Corporation
• Economy Drug Inc
• Stacey Ann Finneman
• Holly Gaugler
• George S Hsu (Elgin Clinic)
• George S. Hsu (Glen Ullin Clinic Elgin Clinic)
• Deepak Manmohan Goyal, MD

• Clinic/Center in Elgin, ND
• Providers in Elgin, ND by specialty
• Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.