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
- Last updated
- Jun 29, 2021
- 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 DirectoryLocations
2 River Pl
Lansing, IL 60438
Phone (708) 474-7404
NPI 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.