Organization Active NPI

Family Vision Center of la Crosse

  • Optometrist
  • La Crosse, WI
National Provider Identifier
1154518967
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY VISION CENTER OF LA CROSSE
Practice address
3424 Mormon Coulee Rd
Ste a
La Crosse, WI 54601-6750
Phone
(608) 788-4300
Fax
(608) 788-4325
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Authorized official

Name
Ann M Wonderling, ODNPI 1154397024
Title
Owner/Optometrist
Phone
(608) 788-4300

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)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3424 Mormon Coulee Rd
Ste a
La Crosse, WI 54601-6750

Mailing address

3424 Mormon Coulee Rd
Ste a
La Crosse, WI 54601-6750
Phone (608) 788-4300

Other names 1

  • Richard L Foss, O.D. dba Family Vision Center of LaCrosse LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170124001062 WI Part B Supplier - Clinic/Group Practice 8224310420 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: La Crosse, WI; Tomah, WI
O20170504000718 WI DME Supplier - Physician - OptometristDME Supplier - Optician 8224310420 Practice locations: La Crosse, WI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Family Vision Center of la Crosse3424 Mormon Coulee Rd, La Crosse, WI 54601-6703(608) 788-4300 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 10, 2017

National Provider Directory

National Provider Directory

Locations

3424 Mormon Coulee Rd
Ste A
La Crosse, WI 54601
Phone (608) 788-4300

1825 N Superior Ave
Ste 3
Tomah, WI 54660
Phone (608) 372-4664

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1154518967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 MORMON COULEE RD",
            "address_2": "STE A",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016750",
            "telephone_number": "608-788-4300",
            "fax_number": "608-788-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 MORMON COULEE RD",
            "address_2": "STE A",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016750",
            "telephone_number": "608-788-4300",
            "fax_number": "608-788-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY VISION CENTER OF LA CROSSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "WONDERLING",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "608-788-4300",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richard L Foss, O.D. dba Family Vision Center of LaCrosse LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.