NPIMap

Organization Active NPI

Vision Mart, Inc

  • Optician
  • Green Bay, WI
National Provider Identifier
1346525573
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
VISION MART, INC
Practice address
2476 S Oneida St
Suite 105
Green Bay, WI 54304-5289
Phone
(920) 965-0260
Fax
(920) 965-0262
NPI assigned
Oct 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Ms. Vicki Dickman
Title
Pres
Phone
(414) 462-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

2476 S Oneida St
Suite 105
Green Bay, WI 54304-5289

Mailing address

12000 W Carmen Ave
Milwaukee, WI 53225-2116
Phone (414) 462-1300

Other identifiers 1

IdentifierTypeStateIssuer
3845000MedicaidWI

Other names 1

  • VISION MART Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vision Mart Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1346525573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 W CARMEN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532252116",
            "telephone_number": "414-462-1300",
            "fax_number": "414-462-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2476 S ONEIDA ST",
            "address_2": "SUITE 105",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045289",
            "telephone_number": "920-965-0260",
            "fax_number": "920-965-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION MART, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "DICKMAN",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "414-462-1300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3845000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISION MART",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.