Organization Active NPI

The Center for Vision Development, LLC

  • Vision Therapy Optometrist
  • Annapolis, MD
National Provider Identifier
1629201991
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
TA1673 Issued in MD
Legal business name
THE CENTER FOR VISION DEVELOPMENT, LLC
Practice address
509 S Cherry Grove Ave Ste C
Annapolis, MD 21401-4235
Phone
(410) 268-4393
Fax
(410) 268-5200
NPI assigned
Sep 2, 2009
Last updated
Mar 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Authorized official

Name
Dr. Jennifer J Kungle, O.D.NPI 1831126911
Title
President
Phone
(301) 437-1266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WV0400X TA1673 MD Primary

Addresses

Primary practice location

509 S Cherry Grove Ave Ste C
Annapolis, MD 21401-4235

Mailing address

509 S Cherry Grove Ave Ste C
Annapolis, MD 21401-4235
Phone (410) 268-4393

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091116000379 MD Part B Supplier - Clinic/Group Practice 7214075084 Receives reassigned benefits from 3 practitioners
Practice locations: Annapolis, MD

National Provider Directory

National Provider Directory

Locations

2525 Riva Rd
Ste 126
Annapolis, MD 21401
Phone (410) 268-4393

509 S Cherry Grove Ave
Ste C
Annapolis, MD 21401
Phone (410) 268-4393

Practitioners & affiliated clinicians

Practitioners 3

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": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1629201991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 S CHERRY GROVE AVE STE C",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014235",
            "telephone_number": "410-268-4393",
            "fax_number": "410-268-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 S CHERRY GROVE AVE STE C",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014235",
            "telephone_number": "410-268-4393",
            "fax_number": "410-268-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR VISION DEVELOPMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-02",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "KUNGLE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-437-1266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "MD",
            "license": "TA1673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.