NPIMap

Organization Active NPI

Midline Vision Group, LLC

  • Optometrist
  • Brookfield, WI
National Provider Identifier
1275248429
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MIDLINE VISION GROUP, LLC
Practice address
17550 W Bluemound Rd
Brookfield, WI 53045-2928
Phone
(262) 784-3700
NPI assigned
Jan 20, 2023
Last updated
Jan 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Authorized official

Name
Michelle Huber
Title
Manager Cbo
Phone
(715) 298-3486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

17550 W Bluemound Rd
Brookfield, WI 53045-2928

Mailing address

408 N 3Rd St Ste 402
Wausau, WI 54403-5455
Phone (715) 298-3486

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pvbrookfield@midlinevision.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Midline Vision Group LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

17550 W Bluemound Rd
Brookfield, WI 53045
Phone (262) 784-3700

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1275248429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N 3RD ST STE 402",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035455",
            "telephone_number": "715-298-3486",
            "fax_number": "715-298-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17550 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452928",
            "telephone_number": "262-784-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLINE VISION GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "HUBER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "MANAGER CBO",
        "authorized_official_telephone_number": "715-298-3486"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pvbrookfield@midlinevision.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17550 W Bluemound Rd",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530452928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.