Organization Active NPI

West Milton Vision Center, LLC

  • Optometrist
  • West Milton, OH
National Provider Identifier
1255913190
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WEST MILTON VISION CENTER, LLC
Practice address
1105 S Miami St
West Milton, OH 45383-1262
Phone
(937) 698-5171
Fax
(937) 698-3600
NPI assigned
Apr 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Authorized official

Name
Dr. Gregory J Stucke, ODNPI 1689982704
Title
President
Phone
(513) 398-3886

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

1105 S Miami St
West Milton, OH 45383-1262

Mailing address

1105 S Miami St
West Milton, OH 45383-1262
Phone (937) 698-5171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210603002379 OH Part B Supplier - Clinic/Group Practice 8527467026 Receives reassigned benefits from 4 practitioners
Practice locations: West Milton, OH

National Provider Directory

National Provider Directory

Locations

1105 S Miami St
West Milton, OH 45383
Phone (937) 698-5171

21 N Miami St
West Milton, OH 45383
Phone (513) 698-5171

Practitioners & affiliated clinicians

Practitioners 4

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": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1255913190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 S MIAMI ST",
            "city": "WEST MILTON",
            "state": "OH",
            "postal_code": "453831262",
            "telephone_number": "937-698-5171",
            "fax_number": "937-698-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 S MIAMI ST",
            "city": "WEST MILTON",
            "state": "OH",
            "postal_code": "453831262",
            "telephone_number": "937-698-5171",
            "fax_number": "937-698-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MILTON VISION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "STUCKE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-398-3886",
        "authorized_official_name_prefix": "Dr.",
        "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": []
}

Other providers in West Milton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.