Fremont Vision Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

885 Issued in NE

Legal business name

FREMONT VISION CORPORATION

Practice address

1625 E Military Ave
Fremont, NE 68025-5463

Phone

(402) 721-0409

Fax

(402) 721-0409

NPI assigned

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Christopher G Fornoff, O.D.

Title

Owner

Phone

(402) 721-0409

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1356532873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 E MILITARY AVE",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680255463",
            "telephone_number": "402-721-0409",
            "fax_number": "402-721-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E MILITARY AVE",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680255463",
            "telephone_number": "402-721-0409",
            "fax_number": "402-721-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT VISION CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "FORNOFF",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-721-0409",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Fremont, NE
• Providers in Fremont, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.