Siren Family Eyecare, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2728 Issued in WI

Legal business name

SIREN FAMILY EYECARE, LLC

Practice address

24082 State Road 35
Siren, WI 54872

Phone

(715) 349-2733

Fax

(715) 349-2744

NPI assigned

Jun 11, 2007

Last updated

Jun 21, 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. Brian Darrell Smith, O.D.NPI 1366483612

Title

Member

Phone

(715) 349-2733

Specialties & licenses 1

Addresses

Other identifiers 5

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 2

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.

• Brian Darrell Smith, O.D.

  • Optometrist
  • Milltown, WI
  • NPI 1366483612
  Medicare reassignment Care Compare group NPD Authorized official
• April Dawn Svoboda Smith, OD

  • Optometrist
  • Siren, WI
  • NPI 1861464307
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1063616571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 290",
            "address_2": "24082 STATE ROAD 35",
            "city": "SIREN",
            "state": "WI",
            "postal_code": "548720290",
            "telephone_number": "715-349-2733",
            "fax_number": "715-349-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24082 STATE ROAD 35",
            "city": "SIREN",
            "state": "WI",
            "postal_code": "54872",
            "telephone_number": "715-349-2733",
            "fax_number": "715-349-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIREN FAMILY EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DARRELL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "715-349-2733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH OF EAU CLAIRE",
            "identifier": "38725900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA EYEWEAR PIN",
            "identifier": "21-00884",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38725900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "57568",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA/OPTUM HEALTH",
            "identifier": "47955",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi Reed, RN
• Michael R Rossow
• School District of Siren
• Debra Jill Severson, MS LPC
• Siren Chiropractic, LLC
• St. Croix Chippewa Indians of Wi (Siren Pharmacy)
• Travis Lee Stanford, D.C.
• Cindy Stewart, SAC-IT
• Warren D Stouffer, CADC II
• April Dawn Svoboda Smith, OD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.