Organization Active NPI

Schlaefer Optometrists

  • Clinic/Center
  • Campbellsport, WI
National Provider Identifier
1154557817
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SCHLAEFER OPTOMETRISTS
Practice address
128 W Main St.
Campbellsport, WI 53010
Phone
(920) 533-8426
Fax
(920) 533-8380
NPI assigned
Jun 8, 2009
Last updated
Jun 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Authorized official

Name
Ann Therese Schlaefer, ODNPI 1548257728
Title
Owner
Phone
(920) 533-8426

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

128 W Main St.
Campbellsport, WI 53010

Mailing address

128 W Main St.
P.O. Box 209
Campbellsport, WI 53010
Phone (920) 533-8426

Other identifiers 1

IdentifierTypeStateIssuer
38586400MedicaidWI

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
Schlaefer Optometrists128 W Main St, Campbellsport, WI 53010-2704(920) 533-8426 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 2, 2008

National Provider Directory

National Provider Directory

Locations

128 W Main St
Campbellsport, WI 53010
Phone (920) 533-4374

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244419200000",
    "number": "1154557817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 W MAIN ST.",
            "address_2": "P.O. BOX 209",
            "city": "CAMPBELLSPORT",
            "state": "WI",
            "postal_code": "53010",
            "telephone_number": "920-533-8426",
            "fax_number": "920-533-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W MAIN ST.",
            "city": "CAMPBELLSPORT",
            "state": "WI",
            "postal_code": "53010",
            "telephone_number": "920-533-8426",
            "fax_number": "920-533-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHLAEFER OPTOMETRISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-06-08",
        "status": "A",
        "authorized_official_last_name": "SCHLAEFER",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-533-8426",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38586400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsport, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.