Visionary Eyecare LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003479A Issued in IN

Legal business name

VISIONARY EYECARE LLC

Doing business as

Visionary Eyecare

Practice address

207 E Lewis and Clark Pkwy
Clarksville, IN 47129

Phone

(812) 945-2573

Fax

(812) 945-2536

NPI assigned

Oct 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Patrick Dice, O.D.NPI 1508813270

Title

Proprietor

Phone

(812) 945-2573

Specialties & licenses 1

Addresses

Other names 1

• Visionary Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

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

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.

• Kelly Patrick Dice, O.D.

  • Optometrist
  • Clarksville, IN
  • NPI 1508813270
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1306025333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 E LEWIS AND CLARK PKWY",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "47129",
            "telephone_number": "812-945-2573",
            "fax_number": "812-945-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E LEWIS AND CLARK PKWY",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "47129",
            "telephone_number": "812-945-2573",
            "fax_number": "812-945-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "DICE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "812-945-2573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003479A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visionary Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordan T Tyree, RBT
• Sarah Vanlsenberg
• Miranda Veatch
• Myrna Velazquez, FNP
• Alanna Vessels
• Anita Maria Vivanco
• Meagan K Voight, RBT
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1476)
• Wal-Mart Stores East, LP (Vision Center 30-1476)
• Walgreen Co (Rite Aid #16574)

• Optometrist in Clarksville, IN
• Providers in Clarksville, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.