Organization Active NPI

Envision Optometry LLC

  • Optometrist
  • Marion, IL
National Provider Identifier
1083402671
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ENVISION OPTOMETRY LLC
Practice address
102 E Deyoung St Ste C
Marion, IL 62959-2724
Phone
(618) 201-8585
NPI assigned
Apr 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Authorized official

Name
Ashley Aylesworth, ODNPI 1518319029
Title
Owner
Phone
(618) 201-8585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

102 E Deyoung St Ste C
Marion, IL 62959-2724

Mailing address

205 Archelle Dr
Carbondale, IL 62901-1956
Phone (618) 201-8585

National Provider Directory

National Provider Directory
Tax ID family
Envision Optometry 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.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1745539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1083402671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ARCHELLE DR",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011956",
            "telephone_number": "618-201-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E DEYOUNG ST STE C",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629592724",
            "telephone_number": "618-201-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-25",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "AYLESWORTH",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-201-8585",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.