Active NPI
Vision Care Center of Idaho LLC
- Ambulatory Surgical Clinic/Center
- Meridian, ID
National Provider Identifier
1083674196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- VISION CARE CENTER OF IDAHO LLC
- Practice address
- 3071 E Franklin Rd
Suite 101
Meridian, ID 83642-2376 - Phone
- (208) 288-1400
- Fax
- (208) 855-0104
- NPI assigned
- Mar 23, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Nancy McHugh
- Title
- Administrator
- Phone
- (208) 288-1400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
3071 E Franklin Rd
Suite 101
Meridian, ID 83642-2376
Mailing address
3071 E Franklin Rd
Suite 101
Meridian, ID 83642-2376
Phone (208) 288-1400
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010029517 | Other | ID | BLUE SHILED |
| FIRST HEALTH CCN | Other | ID | 2090664 |
| 04101 | Other | ID | BLUE CROSS |
| 805861000 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100715000703 | ID | Part B Supplier - Ambulatory Surgical Center | 7214069913 | Practice locations: Meridian, ID |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Vision Care Center of Idaho LLC
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D0975825 | Vision Care Center of Idaho | Certificate of waiver | Jul 18, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Ophthalmology Physician
- Mayfield HTS, OH
- NPI 1306251038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1278979200000",
"number": "1083674196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3071 E FRANKLIN RD",
"address_2": "SUITE 101",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836422376",
"telephone_number": "208-288-1400",
"fax_number": "208-855-0104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3071 E FRANKLIN RD",
"address_2": "SUITE 101",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836422376",
"telephone_number": "208-288-1400",
"fax_number": "208-855-0104"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VISION CARE CENTER OF IDAHO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-23",
"last_updated": "2010-07-13",
"status": "A",
"authorized_official_last_name": "MCHUGH",
"authorized_official_first_name": "NANCY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "208-288-1400",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHILED",
"identifier": "000010029517",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "2090664",
"identifier": "FIRST HEALTH CCN",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "04101",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805861000",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.