SVS Vision Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SVS VISION INC

Practice address

20330 West Rd
Woodhaven, MI 48183-3321

Phone

(734) 675-8197

Fax

(734) 675-8289

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert G Farrell Jr., OD

Title

Owner/Ceo

Phone

(586) 468-7370

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• SVS VISION 35 Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1114052925",
    "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": "20330 WEST RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481833321",
            "telephone_number": "734-675-8197",
            "fax_number": "734-675-8289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SVS VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "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": "Mr.",
        "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": "4500418",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SVS VISION 35",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SVS VISION 35",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• South Allen Medical Group PLLC
• Nicole Danielle Spence, RN
• Daniel St Amour, NP-C
• Renee St Louis, COTA/L
• Kaylee Stamper
• Robyn Swanson, O.D.
• Conchita Tanhehco, M.D.
• Angela Taylor, OD
• The Bridge Center for Growth, PC.
• Anthony Scott Thomas, PHARMD

• Optometrist in Woodhaven, MI
• Providers in Woodhaven, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.