Eye Wisconsin LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYE WISCONSIN LLC

Practice address

1721 W Main St
Sun Prairie, WI 53590-3161

Phone

(608) 837-7325

NPI assigned

Jul 10, 2023

Organization subpart

Yes

Parent organization

EYE WISCONSIN LLCAs reported in NPPES

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

Authorized official

Name

Dr. Bradley Grant, ODNPI 1386836518

Title

Owner

Phone

(217) 233-3101

Specialties & licenses 1

Addresses

Tax ID family

Eye Wisconsin LLC2 organizations share this tax ID, including this one

Part of

Eye Wisconsin LLC

Other organizations with this tax ID 1

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

• Eye Wisconsin LLC

  • Optometrist
  • Waterford, WI
  • NPI 1487392585
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Eye Wisconsin LLC

  • Optometrist
  • Waterford, WI
  • NPI 1487392585
  NPPES parent name

Practitioners 1

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

• Bradley Stewart Grant, O.D.

  • Optometrist
  • Bloomington, IL
  • NPI 1386836518
  NPD Authorized official

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1396423273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 BUCKS POND RD",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618568058",
            "telephone_number": "217-233-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 W MAIN ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535903161",
            "telephone_number": "608-837-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE WISCONSIN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE WISCONSIN LLC",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-233-3101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.