Innovative Vision Therapy Center

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

Legal business name

INNOVATIVE VISION THERAPY CENTER

Practice address

3215 Martin Luther King Jr Blvd Ste O
Anderson, SC 29625-1715

Phone

(864) 540-8404

NPI assigned

Oct 16, 2017

Last updated

Oct 16, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tabitha JohnsonNPI 1063943231

Title

Owner

Phone

(864) 540-8404

Specialties & licenses 2

Addresses

Locations

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.

• Tabitha Johnson

  • Technician/Technologist
  • Anderson, SC
  • NPI 1063943231
  NPD (past) Authorized official

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1265943450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 MARTIN LUTHER KING JR BLVD STE O",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296251715",
            "telephone_number": "864-540-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 MARTIN LUTHER KING JR BLVD STE O",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296251715",
            "telephone_number": "864-540-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE VISION THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TABITHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-540-8404"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lori Insera, LMFT
• Inspiring Change Professional Counseling Services
• Integrated Physical Therapy LLC
• Internal Medicine Associates of Anderson, PA
• Ingrid L Isakov Kyriakakis, MD

• Vision Therapy Optometrist in Anderson, SC
• Providers in Anderson, SC by specialty
• Vision Therapy Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.