Organization Active NPI

DRS Williams & Vihlen PA

  • Eyewear Supplier
  • Leesburg, FL
National Provider Identifier
1275600892
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
DRS WILLIAMS & VIHLEN PA
Practice address
112 E Dixie Ave
Leesburg, FL 34748-6350
Phone
(352) 787-1956
Fax
(352) 365-6690
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Authorized official

Name
Dr. Samuel W Williams, OD
Title
President
Phone
(352) 787-1956

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

112 E Dixie Ave
Leesburg, FL 34748-6350

Mailing address

112 E Dixie Ave
Leesburg, FL 34748-6350
Phone (352) 787-1956

Other identifiers 1

IdentifierTypeStateIssuer
008872400MedicaidFL

Other names 1

  • Eyecare Center of Leesburg Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eyecare Center of Leesburg112 E Dixie Ave, Leesburg, FL 34748-6350(352) 787-1956 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Nov 10, 2017

National Provider Directory

National Provider Directory
Tax ID family
Coren Eye Group PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386115200000",
    "number": "1275600892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486350",
            "telephone_number": "352-787-1956",
            "fax_number": "352-365-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486350",
            "telephone_number": "352-787-1956",
            "fax_number": "352-365-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS WILLIAMS & VIHLEN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2013-12-04",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-787-1956",
        "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": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008872400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyecare Center of Leesburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.