NPIMap

Organization Active NPI

Family Vision & Contact Lens Centers, S.C.

  • Optometrist
  • Burlington, WI
National Provider Identifier
1053084087
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY VISION & CONTACT LENS CENTERS, S.C.
Practice address
309 McHenry St
Burlington, WI 53105-2123
Phone
(262) 763-0117
Fax
(262) 763-0119
NPI assigned
Jul 27, 2021
Last updated
Jul 27, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY VISION & CONTACT LENS CENTERS, S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Authorized official

Name
Michelle Schmalfeldt
Title
Insurance Coordinator
Phone
(262) 763-0117

Specialties & licenses 1

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

Addresses

Primary practice location

309 McHenry St
Burlington, WI 53105-2123

Mailing address

PO Box 630
Burlington, WI 53105-0630
Phone (262) 763-0117

National Provider Directory

National Provider Directory
Tax ID family
David M Ebley OD5 organizations share this tax ID, including this one
Part of
David M Ebley OD

Other organizations with this tax ID 4

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1053084087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531050630",
            "telephone_number": "262-763-0117",
            "fax_number": "262-763-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052123",
            "telephone_number": "262-763-0117",
            "fax_number": "262-763-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY VISION & CONTACT LENS CENTERS, S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY VISION & CONTACT LENS CENTERS, S.C.",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "SCHMALFELDT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "262-763-0117"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.