Full Sail Partners, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

FULL SAIL PARTNERS, LLC

Doing business as

Vision Center of Plymouth

Practice address

215 N Michigan St
Plymouth, IN 46563-2134

Phone

(574) 936-8144

NPI assigned

Feb 8, 2010

Organization subpart

No

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

Authorized official

Name

Eric J Bertrand

Title

Owner

Phone

(574) 936-8144

Specialties & licenses 1

Addresses

Other names 1

• Vision Center of Plymouth Doing business as

Tax ID family

Full Sail Partners LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Full Sail Partners

  dba Vision Center @ Meijer

  • Ophthalmology Physician
  • Canal Winchester, OH
  • NPI 1922273226
  NPD tax ID
• Full Sail Partners, LLC

  • Ophthalmology Physician
  • Battle Creek, MI
  • NPI 1679726798
  NPD tax ID

Locations

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1235461708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N MICHIGAN ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465632134",
            "telephone_number": "574-936-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N MICHIGAN ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465632134",
            "telephone_number": "574-936-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SAIL PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "BERTRAND",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-936-8144"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Center of Plymouth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nanette Arone Fredericks, LCSW
• Kathleen C Freet, MSW, LCSW
• Joseph Fried, MSW, LCSW
• Benjamin Cale Friesen
• Courtney A Fuchs, OTR
• Nicole Furlong
• Bryttenny Shyanne Gaines, MSW
• Jodie Kay Gaines, LCSW, LCAC
• Kelly Gaines
• Galen Inpatient Physicians PC

• Optometrist in Plymouth, IN
• Providers in Plymouth, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.