NPIMap

Organization Active NPI

Maryland Vision Institute, LLC

  • Optometrist
  • Hagerstown, MD
National Provider Identifier
1033528112
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARYLAND VISION INSTITUTE, LLC
Practice address
220 Champion Dr
Suite 100
Hagerstown, MD 21740-6558
Phone
(301) 791-0888
Fax
(301) 791-3611
NPI assigned
Aug 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Authorized official

Name
Kara Vittetoe
Title
Practice Administrator
Phone
(301) 791-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

220 Champion Dr
Suite 100
Hagerstown, MD 21740-6558

Mailing address

220 Champion Dr
Suite 100
Hagerstown, MD 21740-6558
Phone (301) 791-0888

Other identifiers 1

IdentifierTypeStateIssuer
6503039MedicaidMD

Other names 1

  • MARYLAND VISION INSTITUTE OPTICIANS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maryland Vision Institute LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505174400000",
    "number": "1033528112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CHAMPION DR",
            "address_2": "SUITE 100",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406558",
            "telephone_number": "301-791-0888",
            "fax_number": "301-791-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CHAMPION DR",
            "address_2": "SUITE 100",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406558",
            "telephone_number": "301-791-0888",
            "fax_number": "301-791-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND VISION INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-04",
        "last_updated": "2017-09-12",
        "status": "A",
        "authorized_official_last_name": "VITTETOE",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "301-791-0888"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6503039",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARYLAND VISION INSTITUTE OPTICIANS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; 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.