NPIMap

Organization Active NPI

Vision Mart, Inc

  • Optician
  • Glendale, WI
National Provider Identifier
1013461771
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
VISION MART, INC
Practice address
130 E Capitol Dr
Glendale, WI 53212-1206
Phone
(414) 962-6744
Fax
(414) 962-6746
NPI assigned
Aug 11, 2016
Organization subpart
Yes
Parent organization
VISION MART, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Authorized official

Name
Victoria Dickman
Title
President
Phone
(414) 462-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

130 E Capitol Dr
Glendale, WI 53212-1206

Mailing address

12000 W Carmen Ave
Milwaukee, WI 53225-2116
Phone (414) 462-1300

Other identifiers 1

IdentifierTypeStateIssuer
3845000MedicaidWI

Other names 1

  • VISION MART Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vision Mart Inc11 organizations share this tax ID, including this one
Part of
Vision Mart Inc

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

130 E Capitol Dr
Milwaukee, WI 53212
Phone (414) 962-6744

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1013461771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 W CARMEN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532252116",
            "telephone_number": "414-462-1300",
            "fax_number": "414-462-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E CAPITOL DR",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121206",
            "telephone_number": "414-962-6744",
            "fax_number": "414-962-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION MART, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VISION MART, INC",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "DICKMAN",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-462-1300"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3845000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISION MART",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.