Active NPI
Family Eye Care of Lake Geneva, S.C.
- Optometrist
- Lake Geneva, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3133-035
- Legal business name
- FAMILY EYE CARE OF LAKE GENEVA, S.C.
- Practice address
- 835 Geneva Pkwy N Ste 3
Lake Geneva, WI 53147-5700 - Phone
- (262) 248-4878
- Fax
- (262) 248-1100
- NPI assigned
- Apr 15, 2009
- 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. Jessica Dixon Heinke, O.D.
- Title
- President
- Phone
- (262) 248-4878
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3133-035 | WI | Primary |
Addresses
Primary practice location
835 Geneva Pkwy N Ste 3
Lake Geneva, WI 53147-5700
Mailing address
835 Geneva Pkwy N Ste 3
Lake Geneva, WI 53147-5700
Phone (262) 248-4878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
835 Geneva Pkwy N
Ste 3
Lake Geneva, WI 53147
Phone (262) 248-3800
835 Geneva Pkwy N
Lake Geneva, WI 53147
Phone (262) 248-4878
415 Broad St
Unit 1
Lake Geneva, WI 53147
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Oconomowoc, WI
- NPI 1831223338
-
- Optometrist
- Sarasota, FL
- NPI 1538399928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239753600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1663113600000",
"number": "1144463571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 GENEVA PKWY N STE 3",
"city": "LAKE GENEVA",
"state": "WI",
"postal_code": "531475700",
"telephone_number": "262-248-4878",
"fax_number": "262-248-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 GENEVA PKWY N STE 3",
"city": "LAKE GENEVA",
"state": "WI",
"postal_code": "531475700",
"telephone_number": "262-248-4878",
"fax_number": "262-248-1100"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY EYE CARE OF LAKE GENEVA, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2009-04-15",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A",
"authorized_official_last_name": "HEINKE",
"authorized_official_first_name": "JESSICA",
"authorized_official_middle_name": "DIXON",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "262-248-4878",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "WI",
"license": "3133-035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Geneva, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.