Advanced Vision Care PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

2848 Issued in MN

Legal business name

ADVANCED VISION CARE PA

Doing business as

Valley Eye Clinic and Optical

Practice address

223 1St St E Ste 101
Jordan, MN 55352-1563

Phone

(952) 492-2350

Fax

(952) 492-6162

NPI assigned

May 1, 2007

Last updated

Dec 28, 2011By 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

Dr. Vicki S Luehmann, OD

Title

Optometrist /Co-Owner

Phone

(952) 492-2350

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Valley Eye Clinic and Optical Doing business as

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1053532929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 1ST ST E STE 101",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553521563",
            "telephone_number": "952-492-2350",
            "fax_number": "952-492-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 1ST ST E STE 101",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553521563",
            "telephone_number": "952-492-2350",
            "fax_number": "952-492-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VISION CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "LUEHMANN",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OPTOMETRIST /CO-OWNER",
        "authorized_official_telephone_number": "952-492-2350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS CLINIC ID",
            "identifier": "110122",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN CLINIC ID",
            "identifier": "340K6VA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480110500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Eye Clinic and Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aegis Group Practice LLC
• Alliance Medical Care Centers
• Kylee Breanne Anderson
• Mary Bauer, MA, LADC, MFT INTERN
• Sally Irene Beck, LMFT, PHD

• Optometrist in Jordan, MN
• Providers in Jordan, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; 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.