Organization Active NPI

Avc Optometry Inc

Doing business as Advanced Vision Care

  • Optometrist
  • Belleville, IL
National Provider Identifier
1295318640
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AVC OPTOMETRY INC
Doing business as
Advanced Vision Care
Practice address
3540 N Belt W Ste C
Belleville, IL 62226-5975
Phone
(618) 235-4433
Fax
(618) 235-7483
NPI assigned
May 4, 2021
Last updated
May 4, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
AVC OPTOMETRY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Authorized official

Name
Joshua David Wilson, ODNPI 1093740821
Title
Owner
Phone
(618) 327-3231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

3540 N Belt W Ste C
Belleville, IL 62226-5975

Mailing address

3540 N Belt W Ste C
Belleville, IL 62226-5975
Phone (618) 235-4433

Other names 1

  • Advanced Vision Care Doing business as

National Provider Directory

National Provider Directory
Part of
Avc Optometry Inc

Locations

3540 N Belt W
Ste C
Belleville, IL 62226
Phone (618) 235-4433

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": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1295318640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 N BELT W STE C",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265975",
            "telephone_number": "618-235-4433",
            "fax_number": "618-235-7483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 N BELT W STE C",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265975",
            "telephone_number": "618-235-4433",
            "fax_number": "618-235-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVC OPTOMETRY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVC OPTOMETRY INC",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-327-3231",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.