1 Vision S.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2324 Issued in WI

Legal business name

1 VISION S.C.

Practice address

150A County Rd B
Shawano, WI 54166-7072

Phone

(715) 526-3163

Fax

(715) 526-4019

NPI assigned

Jan 6, 2006

Last updated

May 17, 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

Mr. Thomas G Peterson, O.D.NPI 1114043387

Title

O.D. - President

Phone

(715) 526-3163

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 8

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.

• Thomas G Peterson, O.D.

  • Optometrist
  • Shawano, WI
  • NPI 1114043387
  Medicare reassignment NPD Authorized official
• Kavit Lache Beyersdorf, OD

  • Optometrist
  • Shawano, WI
  • NPI 1447489661
  Medicare reassignment NPD
• Nicole Jeannine Klotzbuecher, OD

  • Optometrist
  • Shawano, WI
  • NPI 1134641848
  Medicare reassignment NPD
• Todd William Wild, OD

  • Optometrist
  • Weyauwega, WI
  • NPI 1992737704
  Medicare reassignment NPD
• Jacob Wittman, OD

  • Optometrist
  • Appleton, WI
  • NPI 1386160521
  Medicare reassignment NPD
• Roxanne Doyle Keszo, OD

  • Optometrist
  • Shawano, WI
  • NPI 1821063009
  Medicare reassignment
• Michelle Marie Mueller, O.D.

  • Optometrist
  • Green Bay, WI
  • NPI 1003867961
  NPD (past)
• Nelson Howard Hassell, O.D.

  • Optometrist
  • Kingsford, MI
  • NPI 1689771487
  NPD (past)

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652745600000",
    "number": "1033197397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541660513",
            "telephone_number": "715-526-3163",
            "fax_number": "715-526-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150A COUNTY RD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-526-3163",
            "fax_number": "715-526-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1 VISION S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "O.D. - PRESIDENT",
        "authorized_official_telephone_number": "715-526-3163",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Shawano, WI
• Providers in Shawano, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.