FR Vision 360, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

FR VISION 360, INC.

Practice address

111 E Morton Ave
Jacksonville, IL 62650-3059

Phone

(217) 883-4553

Fax

(217) 883-4576

NPI assigned

Jan 21, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Benjamin J Ribble

Title

Corporate Secretary

Phone

(217) 391-4699

Specialties & licenses 1

Addresses

Other names 1

• Pearle Vision 8142 Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Lori Ann Feezor-Ribble, O.D.

  • Optometrist
  • Jacksonville, IL
  • NPI 1376593038
  Medicare reassignment NPD

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1194355917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 TIMBER VIEW RD",
            "city": "FRANKLIN",
            "state": "IL",
            "postal_code": "626385073",
            "telephone_number": "217-391-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E MORTON AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503059",
            "telephone_number": "217-883-4553",
            "fax_number": "217-883-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FR VISION 360, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "RIBBLE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "217-391-4699",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision 8142",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pearle Vision 8142",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Eyewear Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; 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.