NPIMap

Organization Active NPI

Midwest Vision Care, LLC

  • Vision Therapy Optometrist
  • Columbia, IL
National Provider Identifier
1447349873
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
Legal business name
MIDWEST VISION CARE, LLC
Practice address
915 N Main St
Suite 1
Columbia, IL 62236-1136
Phone
(618) 281-2400
NPI assigned
Oct 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kelly K Kerksick, OD
Title
Optometrist
Phone
(618) 281-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WV0400X IL Primary

Addresses

Primary practice location

915 N Main St
Suite 1
Columbia, IL 62236-1136

Mailing address

915 N Main Street
Suite 1
Columbia, IL 62239
Phone (618) 281-2400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447349873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N MAIN STREET",
            "address_2": "SUITE 1",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "62239",
            "telephone_number": "618-281-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N MAIN ST",
            "address_2": "SUITE 1",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361136",
            "telephone_number": "618-281-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST VISION CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KERKSICK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "618-281-2400",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.