Active NPI
SVS Vision Inc
- Optometrist
- Lansing, IL
National Provider Identifier
1508991027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- SVS VISION INC
- Practice address
- 2 River PL
Lansing, IL 60438-6028 - Phone
- (708) 474-7404
- Fax
- (708) 474-7414
- NPI assigned
- Feb 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert G Farrell Jr., OD
- Title
- Owner/Ceo
- Phone
- (586) 468-7370
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary | ||
| Eyewear Supplier | 332H00000X |
Addresses
Primary practice location
2 River PL
Lansing, IL 60438-6028
Mailing address
118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 468-7370
Other names 1
- SVS VISION 28
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110902000019 | IL | Part B Supplier - Clinic/Group Practice | 9931257110 |
1 other NPI on this enrollment Practice locations: Lansing, IL |
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1624924800000",
"number": "1508991027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 CASS AVE",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480432204",
"telephone_number": "586-468-7370",
"fax_number": "586-468-7682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 RIVER PL",
"city": "LANSING",
"state": "IL",
"postal_code": "604386028",
"telephone_number": "708-474-7404",
"fax_number": "708-474-7414"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SVS VISION INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-23",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A",
"authorized_official_last_name": "FARRELL",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "586-468-7370",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SVS VISION 28",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "SVS VISION 28",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Lansing, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.