Midline Vision Clinics SC

Primary specialty

OptometristTaxonomy code 152W00000X

License

3146-35 Issued in WI

Legal business name

MIDLINE VISION CLINICS SC

Practice address

4301 Lien Rd
Madison, WI 53704

Phone

(608) 327-5382

Fax

(608) 467-4556

NPI assigned

Jul 21, 2009

Last updated

Jul 12, 2021By 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

Dr. Jeremy Michael Goetsch, O.D.NPI 1467696526

Title

Manager

Phone

(715) 693-2400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 4

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.

• Jeremy Michael Goetsch, O.D.

  • Optometrist
  • Mosinee, WI
  • NPI 1467696526
  NPD Authorized official
• Jill Marie Germain, O.D.

  • Optometrist
  • Monona, WI
  • NPI 1932388394
  Medicare reassignment
• Kathryn Joan Koslowski Parsons, OD

  • Optometrist
  • Fitchburg, WI
  • NPI 1831759166
  Medicare reassignment
• Chelci S Schade, OD

  • Optometrist
  • Dodgeville, WI
  • NPI 1720571698
  Medicare reassignment

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1114157427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N 3RD ST STE 402",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035455",
            "telephone_number": "608-239-1218",
            "fax_number": "608-467-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 LIEN RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53704",
            "telephone_number": "608-327-5382",
            "fax_number": "608-467-4556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Cormier Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543044404",
            "country_code": "US",
            "telephone_number": "920-499-5873",
            "fax_number": "608-467-4556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 Hilldale Way",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537052644",
            "country_code": "US",
            "telephone_number": "608-298-6001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDLINE VISION CLINICS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "GOETSCH",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "715-693-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3146-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conner Mickelson
• Kira Lynn Mickelson, PT, DPT
• Mid West Hearing LLC (Miracle Ear)
• Sven F Midelfort, ACSW
• Midland Transit LLC
• Thomas T Midthun, MD
• Tonia Lynn Midthun
• Midwest Audiology & Hearing Center Madison, LLC
• Midwest Center for Human Services LLP
• Midwest Jaw Relief SC (Midwest Jaw Relief)

• Optometrist in Madison, WI
• Providers in Madison, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.