The Vision Salon, LTD.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

THE VISION SALON, LTD.

Doing business as

Vision Salon Eye Care Associates

Practice address

12812 Western Ave
Blue Island, IL 60406-2118

Phone

(708) 385-0013

Fax

(708) 385-1175

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ansel T Johnson, O.D.NPI 1023106309

Title

President/Owner

Phone

(708) 385-0013

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vision Salon Eye Care Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Vision Salon Eye Care Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Vision Salon Eye Care Associates

  • Vision Therapy Optometrist
  • Blue Island, IL
  • NPI 1750330411
  NPD tax ID
• Vision Salon Eye Care Associates

  • Optometrist
  • Chicago, IL
  • NPI 1831287861
  NPD tax ID

Locations

Practitioners 6

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.

• Ansel T Johnson, OD

  • Optometrist
  • Blue Island, IL
  • NPI 1023106309
  Medicare reassignment Care Compare group NPD Authorized official
• Dana Shari Shannon, OD

  • Optometrist
  • Westmont, IL
  • NPI 1194498550
  Medicare reassignment Care Compare group NPD
• Leonidas A Johnson, OD

  • Optometrist
  • Blue Island, IL
  • NPI 1912022641
  Medicare reassignment NPD
• Carletta Yvonne Boyd, OD

  • Optometrist
  • Chicago, IL
  • NPI 1023106341
  NPD (past)
• April Sayavong

  • Optometric Technician
  • Blue Island, IL
  • NPI 1740115203
  NPD (past)
• Derek J Dawson, M.D.

  • Ophthalmology Physician
  • Munster, IN
  • NPI 1013992411
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1487727046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12812 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062118",
            "telephone_number": "708-385-0013",
            "fax_number": "708-385-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12812 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062118",
            "telephone_number": "708-385-0013",
            "fax_number": "708-385-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VISION SALON, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANSEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "708-385-0013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL ID",
            "identifier": "1636075",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Salon Eye Care Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberley Jane Tarcak, MSW
• Jesse Taylor, LMT
• The Thresholds (South Suburbs Blue Island Apartments)
• The Thresholds (South Suburbs Residential)
• The Thresholds (South Suburbs CFR/NFC)
• Theodore G James MDSC
• Charmaine Thomas, M.ED, M.S.
• Renjith Thomas
• Gregorio M Tolentino Jr., MD
• Total Nutrition Solutions Inc

• Optometrist in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.