Superior Vision, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

18002637B Issued in IN

Legal business name

SUPERIOR VISION, LLC

Practice address

10922 E County Road 800 S Ste a
Camby, IN 46113-9161

Phone

(317) 856-2000

Fax

(317) 865-2000

NPI assigned

Jan 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dianne E PorterNPI 1467587055

Title

O.D./President

Phone

(812) 320-4362

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

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.

• Dianne Elizabeth Porter, O.D.

  • Optometrist
  • Camby, IN
  • NPI 1467587055
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573430400000",
    "number": "1083890172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8190 WINDFALL LN",
            "address_2": "STE C",
            "city": "CAMBY",
            "state": "IN",
            "postal_code": "461137906",
            "telephone_number": "317-856-2000",
            "fax_number": "317-865-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10922 E COUNTY ROAD 800 S STE A",
            "city": "CAMBY",
            "state": "IN",
            "postal_code": "461139161",
            "telephone_number": "317-856-2000",
            "fax_number": "317-865-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR VISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2019-11-11",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "O.D./PRESIDENT",
        "authorized_official_telephone_number": "812-320-4362",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IN",
            "license": "18002637B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200893590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pamela Sykes
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• Jessica Vinson
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• Clinic/Center in Camby, IN
• Providers in Camby, IN by specialty
• Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.