Knight Vision & Glaucoma Specialists, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2138-035 Issued in WI

Legal business name

KNIGHT VISION & GLAUCOMA SPECIALISTS, INC.

Practice address

7300 W Greenfield Ave
West Allis, WI 53214-4729

Phone

(414) 453-6667

Fax

(414) 774-5505

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Dawn M. Boulanger

Title

Administrator

Phone

(414) 453-2534

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1467558536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144729",
            "telephone_number": "414-453-6667",
            "fax_number": "414-774-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144729",
            "telephone_number": "414-453-6667",
            "fax_number": "414-774-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNIGHT VISION & GLAUCOMA SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "BOULANGER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "414-453-2534",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2138-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38529800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie C Klein, PT
• Amanda Kliber, CNM
• Shannon Marie Klingbeil
• April Kristin Klipstein, FNP-C
• Debra L Kneisler, PAC
• Eric L. Knight, O.D.
• John Paul Knoop, SAC
• Knueppel Healthcare Services, Inc.
• Elizabeth Laura Koenen, M.S. CCC-SLP
• Kathryn E Koenig-Leuck, PSYD

• Optometrist in West Allis, WI
• Providers in West Allis, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.