NPIMap

Organization Active NPI

Valley View Vision SC

  • Optometrist
  • Centuria, WI
National Provider Identifier
1538296363
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2281 Issued in WI
Legal business name
VALLEY VIEW VISION SC
Practice address
416 Superior Avenue
Centuria, WI 54824
Phone
(715) 646-1336
NPI assigned
Feb 28, 2007
Last updated
Oct 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Authorized official

Name
Jodi Ann Bergstrom, O.D.NPI 1568511095
Title
Owner
Phone
(715) 646-1336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2281 WI Primary

Addresses

Primary practice location

416 Superior Avenue
Centuria, WI 54824

Mailing address

PO Box 400
Centuria, WI 54824-0400
Phone (715) 646-1336

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351641600000",
    "number": "1538296363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "CENTURIA",
            "state": "WI",
            "postal_code": "548240400",
            "telephone_number": "715-646-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 SUPERIOR AVENUE",
            "city": "CENTURIA",
            "state": "WI",
            "postal_code": "54824",
            "telephone_number": "715-646-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY VIEW VISION SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-10-31",
        "status": "A",
        "authorized_official_last_name": "BERGSTROM",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-646-1336",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centuria, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.