SE Professionals SC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SE PROFESSIONALS SC

Doing business as

Premier Vision

Practice address

8693 N Port Washington Rd
Fox Point, WI 53217

Phone

(414) 351-2020

Fax

(414) 351-2031

NPI assigned

Oct 24, 2006

Last updated

Oct 31, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David King Aymond, MD

Title

Owner

Phone

(920) 467-7000

Specialties & licenses 1

Addresses

Other names 1

• Premier Vision Doing business as

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351641600000",
    "number": "1558445197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8693 N PORT WASHINGTON RD",
            "city": "FOX POINT",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-351-2020",
            "fax_number": "414-351-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8693 N PORT WASHINGTON RD",
            "city": "FOX POINT",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-351-2020",
            "fax_number": "414-351-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SE PROFESSIONALS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2012-10-31",
        "status": "A",
        "authorized_official_last_name": "AYMOND",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "KING",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-467-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ezedin M Sadeghi, D.D.S.
• Melissa Sargent, PHARMD
• Margaret Mary Schmit, MD
• Norman Schwartz, MD
• Jennifer A Scott, MSW, LCSW
• Syed Yawar Shafi, PHARMD
• Stephanie Smith, DPT
• Peter Stathas
• Heather Elizabeth Stern, OD
• Jamie Lynn Trettin, LPC

• Optometrist in Fox Point, WI
• Providers in Fox Point, WI by specialty
• Optometrist in Wisconsin

• 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.