Advanced Vision Clinic and Optical LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2955 Issued in MN

Legal business name

ADVANCED VISION CLINIC AND OPTICAL LLC

Practice address

1099 Helmo Ave N
Suite 150
Oakdale, MN 55128-6033

Phone

(651) 739-3937

Fax

(651) 739-9690

NPI assigned

Nov 16, 2006

Last updated

Aug 22, 2020By 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

Angela Porch Johnson, OD

Title

Owner Member

Phone

(651) 270-1621

Specialties & licenses 1

Addresses

Other names 1

• Angela P Johnson LLC Former legal business name

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.

• Travis M. Johnson, O.D.

  • Optometrist
  • Murfreesboro, TN
  • NPI 1003890609
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093888349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 HELMO AVE N",
            "address_2": "SUITE 150",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286033",
            "telephone_number": "651-739-3937",
            "fax_number": "651-739-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 HELMO AVE N",
            "address_2": "SUITE 150",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286033",
            "telephone_number": "651-739-3937",
            "fax_number": "651-739-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VISION CLINIC AND OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "PORCH",
        "authorized_official_title_or_position": "OWNER MEMBER",
        "authorized_official_telephone_number": "651-270-1621",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angela P Johnson LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Emmanuel Abrokwah
• Accentcare Fairview Home Health - East, LLC
• Abdinasir Adam
• Beydan A Adam
• Adequate Home Care LLC
• Abdia Ahmed
• Fardowsa Ahmed
• Isse Ahmed
• Ridwan Ahmed
• Zaki Ahmed

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.