NPIMap

Organization Active NPI

Visionworks, Inc.

Doing business as Visionworks

  • Optometrist
  • Independence, MO
National Provider Identifier
1649203308
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISIONWORKS, INC.
Doing business as
Visionworks
Practice address
1004 Independence Center
Independence, MO 64057
Phone
(816) 795-0011
Fax
(816) 795-8267
NPI assigned
Jul 8, 2006
Last updated
Jul 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Authorized official

Name
Dolsie McDonald
Title
MVC Contracts & Credentialing Manag
Phone
(210) 524-6663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1004 Independence Center
Independence, MO 64057

Mailing address

175 E Houston St
San Antonio, TX 78205-2255
Phone (210) 524-6803

Other identifiers 1

IdentifierTypeStateIssuer
507520005MedicaidMO

Other names 1

  • Visionworks Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050506000575 MO Part B Supplier - Clinic/Group Practice 4385639616 Receives reassigned benefits from 33 practitioners
Practice locations: Joplin, MO; Springfield, MO; Saint Peters, MO; Saint Louis, MO; Richmond Heights, MO
O20050606000414 MO Part B Supplier - Clinic/Group Practice 4385639616 Receives reassigned benefits from 30 practitioners
Practice locations: Kansas City, MO; Lees Summit, MO; Saint Joseph, MO; Independence, MO; Cape Girardeau, MO

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Visionworks63 organizations share this tax ID, including this one

Locations

2263 Michigan Ave
Arnold, MO 63010
Phone (636) 287-1459

101 N Range Line Rd
Spc 346
Joplin, MO 64801
Phone (417) 623-8620

8600 Ward Pkwy
Ste 710
Kansas City, MO 64114
Phone (816) 523-8882

2825 S Glenstone Ave
Ste F11
Springfield, MO 65804
Phone (417) 882-3692

Practitioners & affiliated clinicians

Practitioners 59

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.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1649203308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HOUSTON ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052255",
            "telephone_number": "210-524-6803",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 INDEPENDENCE CENTER",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64057",
            "telephone_number": "816-795-0011",
            "fax_number": "816-795-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONWORKS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "DOLSIE",
        "authorized_official_title_or_position": "MVC CONTRACTS & CREDENTIALING MANAG",
        "authorized_official_telephone_number": "210-524-6663"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507520005",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visionworks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.