NPIMap

Organization Active NPI

Visionary Enterprises Inc

  • Prosthetic/Orthotic Supplier
  • Indianapolis, IN
National Provider Identifier
1598073033
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
VISIONARY ENTERPRISES INC
Practice address
1400 N Ritter Ave Ste 145
Figleaf Boutique Che
Indianapolis, IN 46219-3052
Phone
(317) 355-3441
Fax
(317) 351-2423
NPI assigned
Sep 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Authorized official

Name
Mr. Mike Hogan
Title
Ceo
Phone
(317) 621-7409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1400 N Ritter Ave Ste 145
Figleaf Boutique Che
Indianapolis, IN 46219-3052

Mailing address

6626 E 75TH St Ste 200
Attn L Pendleton
Indianapolis, IN 46250-2855
Phone (317) 621-7543

Other identifiers 2

IdentifierTypeStateIssuer
000000718169OtherINANTHEM
201011720AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110426000847 IN DME Supplier - Medical Supply Company 0446154215 Practice locations: Indianapolis, IN

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Visionary Enterprises Inc1400 N Ritter Ave, Indianapolis, IN 46219-3052(317) 355-3441 Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Mar 8, 1992

National Provider Directory

National Provider Directory
Tax ID family
Visionary Enterprises Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1400 N Ritter Ave
Ste 145
Indianapolis, IN 46219
Phone (317) 355-3441

NPI Registry JSON

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548374400000",
    "number": "1598073033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 200",
            "address_2": "ATTN L PENDLETON",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502855",
            "telephone_number": "317-621-7543",
            "fax_number": "317-621-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N RITTER AVE STE 145",
            "address_2": "FIGLEAF BOUTIQUE CHE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193052",
            "telephone_number": "317-355-3441",
            "fax_number": "317-351-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-17",
        "last_updated": "2019-01-25",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-621-7409",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000718169",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201011720A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.