NPIMap

Organization Active NPI

Wisconsin Vision, Inc

Doing business as Heartland Vision

  • Optometrist
  • Avon, IN
National Provider Identifier
1619015716
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WISCONSIN VISION, INC
Doing business as
Heartland Vision
Practice address
9655 E US Highway 36 Ste E
Avon, IN 46123-6212
Phone
(317) 243-5423
Fax
(262) 923-7641
NPI assigned
Feb 1, 2007
Last updated
Aug 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Mr. Darren Thomas Horndasch
Title
President Ceo
Phone
(262) 432-2005

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Optician 156FX1800X NU

Addresses

Primary practice location

9655 E US Highway 36 Ste E
Avon, IN 46123-6212

Mailing address

16800 West Cleveland Ave
New Berlin, WI 53151-3533
Phone (262) 432-2005

Other names 1

  • Heartland Vision Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

Locations

5620 Crawfordsville Rd
Ste A
Speedway, IN 46224
Phone (317) 243-5423

Practitioners & affiliated clinicians

Practitioners 1

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": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1619015716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 WEST CLEVELAND AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531513533",
            "telephone_number": "262-432-2005",
            "fax_number": "262-432-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9655 E US HIGHWAY 36 STE E",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236212",
            "telephone_number": "317-243-5423",
            "fax_number": "262-923-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN VISION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "HORNDASCH",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "262-432-2005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heartland Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.