NPIMap

Organization Active NPI

Park Place Optical, LTD

  • Optician
  • Appleton, WI
National Provider Identifier
1255465738
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
PARK PLACE OPTICAL, LTD
Practice address
21 Park PL
Appleton, WI 54914-8872
Phone
(920) 739-8235
Fax
(920) 749-8095
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Authorized official

Name
Dr. Michael P Vrabec, M.D.
Title
Officer
Phone
(920) 739-8235

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

21 Park PL
Appleton, WI 54914-8872

Mailing address

21 Park PL
Appleton, WI 54914-8872
Phone (920) 739-8235

Other identifiers 1

IdentifierTypeStateIssuer
38424500MedicaidWI

National Provider Directory

National Provider Directory

Locations

21 Park Pl
Appleton, WI 54914
Phone (920) 739-4361

Practitioners & affiliated clinicians

Practitioners 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1255465738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PARK PL",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148872",
            "telephone_number": "920-739-8235",
            "fax_number": "920-749-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PARK PL",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148872",
            "telephone_number": "920-739-8235",
            "fax_number": "920-749-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE OPTICAL, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "VRABEC",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "920-739-8235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38424500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.