Visionary Optometry Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

2835/T598 Issued in OH

Legal business name

VISIONARY OPTOMETRY INC

Practice address

10551 W National Rd
New Carlisle, OH 45344-9299

Phone

(937) 845-9444

Fax

(937) 845-8511

NPI assigned

Aug 15, 2005

Organization subpart

No

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

Authorized official

Name

Noelle K Gehm, ODNPI 1861527939

Title

President

Phone

(937) 845-9444

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Noelle K Gehm, OD

  • Optometrist
  • New Carlisle, OH
  • NPI 1861527939
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580256000000",
    "number": "1386646701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10551 W NATIONAL RD",
            "city": "NEW CARLISLE",
            "state": "OH",
            "postal_code": "453449299",
            "telephone_number": "937-845-9444",
            "fax_number": "937-845-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10551 W NATIONAL RD",
            "city": "NEW CARLISLE",
            "state": "OH",
            "postal_code": "453449299",
            "telephone_number": "937-845-9444",
            "fax_number": "937-845-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A",
        "authorized_official_last_name": "GEHM",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-845-9444",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "2835/T598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046100",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Martin Van Dyke, PT
• Michelle Lynn Van Hook
• Vancrest of New Carlisle
• Vancrest of New Carlisle, LLC
• Sean Verma, DMD
• Jennifer Vito
• Sarah Fox Wagner, LISW-S
• Erin Danielle Williams, LPN
• Ralph Williams
• Kathleen Winterbotham, LPN

• Optometrist in New Carlisle, OH
• Providers in New Carlisle, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.