The Visionary Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002800 Issued in MI

Legal business name

THE VISIONARY INC

Practice address

7333 Allen Rd
Allen Park, MI 48101-1920

Phone

(313) 389-3937

Fax

(313) 389-1113

NPI assigned

Oct 26, 2006

Last updated

Sep 16, 2008By 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

Annette M Prevaux, ABO,NCLEC

Title

President

Phone

(313) 389-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1558446302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7333 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011920",
            "telephone_number": "313-389-3937",
            "fax_number": "313-389-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7333 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011920",
            "telephone_number": "313-389-3937",
            "fax_number": "313-389-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VISIONARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "PREVAUX",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-389-3937",
        "authorized_official_credential": "ABO,NCLEC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "900H268540",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Allen Park, MI
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• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.