NPIMap

Organization Active NPI

Valley Vision Clinic SC

  • Optometrist
  • Neenah, WI
National Provider Identifier
1477522324
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VALLEY VISION CLINIC SC
Practice address
1513 S Commercial St
Neenah, WI 54956-4801
Phone
(920) 725-1566
Fax
(920) 725-8810
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Authorized official

Name
Thomas Rued, O.D.
Title
Owner
Phone
(920) 725-1566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X WI Primary

Addresses

Primary practice location

1513 S Commercial St
Neenah, WI 54956-4801

Mailing address

1513 S Commercial St
Neenah, WI 54956-4801
Phone (920) 725-1566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070919000840 WI Part B Supplier - Clinic/Group Practice 4981798030 Receives reassigned benefits from 2 practitioners
Practice locations: Neenah, WI

National Provider Directory

National Provider Directory

Locations

1513 S Commercial St
Neenah, WI 54956
Phone (920) 725-1566

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1477522324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564801",
            "telephone_number": "920-725-1566",
            "fax_number": "920-725-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564801",
            "telephone_number": "920-725-1566",
            "fax_number": "920-725-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY VISION CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "RUED",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-725-1566",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

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