Organization Active NPI

Wisconsin Vision, Inc.

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1497155915
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WISCONSIN VISION, INC.
Doing business as
Heartland Vision
Practice address
2320 1/2 S Tibbs Ave
Indianapolis, IN 46241-4803
Phone
(262) 432-2005
Fax
(262) 432-2006
NPI assigned
Sep 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Mr. Darren Thomas Horndasch
Title
President/Ceo
Phone
(262) 432-2005

Specialties & licenses 1

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

Addresses

Primary practice location

2320 1/2 S Tibbs Ave
Indianapolis, IN 46241-4803

Mailing address

16800 W Cleveland Ave
New Berlin, WI 53151-3533
Phone (262) 432-2005

Other names 1

  • Heartland Vision Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1497155915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 W CLEVELAND AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531513533",
            "telephone_number": "262-432-2005",
            "fax_number": "262-432-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 1/2 S TIBBS AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462414803",
            "telephone_number": "262-432-2005",
            "fax_number": "262-432-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN VISION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "HORNDASCH",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "262-432-2005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heartland Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.