NPIMap

Organization Active NPI

Vision Care of Maine, LLC Optometry Group

  • Optometrist
  • Bangor, ME
National Provider Identifier
1649356700
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISION CARE OF MAINE, LLC OPTOMETRY GROUP
Practice address
1 Ridgewood Dr
Bangor, ME 04401-2652
Phone
(207) 945-6200
Fax
(207) 990-3015
NPI assigned
Oct 31, 2006
Last updated
Jul 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Lauren Painter
Title
Credentialing Supervisor
Phone
(314) 989-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1 Ridgewood Dr
Bangor, ME 04401-2652

Mailing address

1 Ridgewood Dr
Bangor, ME 04401-2652
Phone (207) 945-6200

Other identifiers 2

IdentifierTypeStateIssuer
1649356700OtherMEDMERC
132650100MedicaidME

National Provider Directory

National Provider Directory
Tax ID family
Vision Care of Maine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

9 Katahdin Ln
Houlton, ME 04730
Phone (207) 532-2974

309 Saint Thomas St
Ste 205
Madawaska, ME 04756
Phone (207) 728-6336

171 Academy St
Presque Isle, ME 04769
Phone (207) 764-4311

Practitioners & affiliated clinicians

Practitioners 7

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": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1649356700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-945-6200",
            "fax_number": "207-990-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-945-6200",
            "fax_number": "207-990-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION CARE OF MAINE, LLC OPTOMETRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "PAINTER",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "314-989-0300"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "1649356700",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132650100",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.