Individual provider Active NPI

Marge Lynne Lebrick, MSED, CVRT

  • Vision Therapy Optometrist
  • Stevens Point, WI
National Provider Identifier
1477986289
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
5294 Issued in AZ
Practice address
3262 Church St
Stevens Point, WI 54481-5321
Phone
(715) 344-4010
NPI assigned
Aug 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 5294 AZ Primary

Addresses

Primary practice location

3262 Church St
Stevens Point, WI 54481-5321

Mailing address

3441 Mirage Circle
Plover, WI 54467
Phone (715) 342-3907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1477986289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 MIRAGE CIRCLE",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "54467",
            "telephone_number": "715-342-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3262 CHURCH ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544815321",
            "telephone_number": "715-344-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBRICK",
        "first_name": "MARGE",
        "middle_name": "LYNNE",
        "credential": "MSED, CVRT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "AZ",
            "license": "5294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.