Chippewa Valley Eye Clinic SC

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

CHIPPEWA VALLEY EYE CLINIC SC

Practice address

2525 CTH I
Chippewa Falls, WI 54729

Phone

(715) 723-6520

Fax

(715) 723-1092

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey F Brown, MD

Title

V Pres

Phone

(715) 723-6520

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Chippewa Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Chippewa Valley Eye Clinic Chippewa Falls SC

  • Ophthalmologic Surgery Clinic/Center
  • Chippewa Falls, WI
  • NPI 1487710638

  0446395800

  Same PAC ID

Tax ID family

Chippewa Valley Eye Clinic Chippewa Falls SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Chippewa Valley Eye Clinic Chippewa Falls SC

  • Ophthalmologic Surgery Clinic/Center
  • Chippewa Falls, WI
  • NPI 1487710638
  NPD tax ID

Practitioners 5

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

• Nicholas Konwinski

  • Optometrist
  • Eau Claire, WI
  • NPI 1730616129
  NPD
• Terrence D McCanna, MD

  • Ophthalmology Physician
  • Chippewa Falls, WI
  • NPI 1285743989
  NPD
• John C Moffitt, MD

  • Ophthalmology Physician
  • Chippewa Falls, WI
  • NPI 1356514053
  NPD
• Kaitlyn Robin Streachek, OD

  • Optometrist
  • Chippewa Falls, WI
  • NPI 1104542521
  NPD
• Mithaq Vahedi, M.D.

  • Ophthalmology Physician
  • Eau Claire, WI
  • NPI 1942565890
  NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508891706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CTH I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "54729",
            "telephone_number": "715-723-6520",
            "fax_number": "715-723-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CTH I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "54729",
            "telephone_number": "715-723-6520",
            "fax_number": "715-723-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIPPEWA VALLEY EYE CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "V PRES",
        "authorized_official_telephone_number": "715-723-6520",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32846300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chippewa Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chippewa Falls Rcac, LLC
• Chippewa Fire Protection District Inc.
• Chippewa Manor Nursing and Rehabilitation Corporation
• Chippewa Pharmacy Inc
• Chippewa Valley Eye Clinic Chippewa Falls SC
• Chippewa Valley Health Cooperative
• Chippewa Valley Independent Psychiatry LLC
• Chippewa Valley Physical Therapy SC
• Chippewa Valley Wound Care, LLC
• Chiro One Wellness Center of Chippewa Falls, LLC

• Optician in Chippewa Falls, WI
• Providers in Chippewa Falls, WI by specialty
• Optician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.