Essential Eyecare, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

3023-035 Issued in WI

Legal business name

ESSENTIAL EYECARE, LLC

Practice address

250 Richmond Way
New Richmond, WI 54017-6829

Phone

(715) 246-2894

Fax

(715) 246-2894

NPI assigned

Aug 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Angela Porch Johnson, O.D.

Title

Member

Phone

(651) 270-1621

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1114150828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 RICHMOND WAY",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540176829",
            "telephone_number": "715-246-2894",
            "fax_number": "715-246-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 RICHMOND WAY",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540176829",
            "telephone_number": "715-246-2894",
            "fax_number": "715-246-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "PORCH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "651-270-1621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3023-035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in New Richmond, WI
• Providers in New Richmond, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.