Organization Active NPI

Vision One Inc

  • Optometrist
  • Daytona Beach, FL
National Provider Identifier
1457308322
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISION ONE INC
Practice address
1900 Mason Ave Ste 100
Daytona Beach, FL 32117-5103
Phone
(386) 274-5525
Fax
(386) 274-5585
NPI assigned
May 27, 2006
Last updated
Mar 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Michael L Haynes, O.D.NPI 1194721001
Title
Owner
Phone
(386) 274-5525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

1900 Mason Ave Ste 100
Daytona Beach, FL 32117-5103

Mailing address

1900 Mason Ave Ste 100
Daytona Beach, FL 32117-5103
Phone (386) 274-5525

Other identifiers 1

IdentifierTypeStateIssuer
620222500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061114000436 FL Part B Supplier - Clinic/Group Practice 9830197623 Receives reassigned benefits from 8 practitioners
Practice locations: Deland, FL; Port Orange, FL; Daytona Beach, FL

National Provider Directory

National Provider Directory

Locations

1900 Mason Ave
Ste 100
Daytona Beach, FL 32117
Phone (386) 274-5525

3820 S Nova Rd
Port Orange, FL 32127
Phone (386) 767-0068

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1457308322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MASON AVE STE 100",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175103",
            "telephone_number": "386-274-5525",
            "fax_number": "386-274-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MASON AVE STE 100",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175103",
            "telephone_number": "386-274-5525",
            "fax_number": "386-274-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION ONE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-274-5525",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620222500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.