Active NPI
SVS Vision Inc
- Optometrist
- Oak Park, MI
National Provider Identifier
1114052172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- SVS VISION INC
- Practice address
- 23055 Coolidge Hwy
Oak Park, MI 48237-2071 - Phone
- (248) 399-1556
- Fax
- (248) 399-2789
- NPI assigned
- Feb 22, 2007
- 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
- Dr. Robert G Farrell Jr., OD
- Title
- Owner/Ceo
- Phone
- (586) 468-7370
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary | ||
| Eyewear Supplier | 332H00000X | MI |
Addresses
Primary practice location
23055 Coolidge Hwy
Oak Park, MI 48237-2071
Mailing address
118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 468-7370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4500490 | Medicaid | MI |
Other names 1
- SVS VISION 10
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090427000507 | MI | Part B Supplier - Clinic/Group Practice | 9931257110 |
Receives reassigned benefits from 109 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryLocations
23055 Coolidge Hwy
Oak Park, MI 48237
Phone (248) 399-1556
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687910400000",
"number": "1114052172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 CASS AVE",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480432204",
"telephone_number": "586-468-7370",
"fax_number": "586-468-7682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23055 COOLIDGE HWY",
"city": "OAK PARK",
"state": "MI",
"postal_code": "482372071",
"telephone_number": "248-399-1556",
"fax_number": "248-399-2789"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SVS VISION INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-22",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A",
"authorized_official_last_name": "FARRELL",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "586-468-7370",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "MI",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4500490",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SVS VISION 10",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "SVS VISION 10",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Oak Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.