Organization Active NPI

Vision Healthcare Provider Services, LLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1689793119
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VISION HEALTHCARE PROVIDER SERVICES, LLC
Practice address
1101 Tyvola Rd Ste 307
Charlotte, NC 28217-3515
Phone
(704) 884-6446
NPI assigned
Mar 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Sharon Elizabeth Garrett, M.ED.
Title
Services Director
Phone
(704) 644-5331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1101 Tyvola Rd Ste 307
Charlotte, NC 28217-3515

Mailing address

1101 Tyvola Rd Ste 307
Charlotte, NC 28217-3515
Phone (704) 884-6446

Other identifiers 1

IdentifierTypeStateIssuer
8301550MedicaidNC

National Provider Directory

National Provider Directory

Locations

1101 Tyvola Rd
Ste 307
Charlotte, NC 28217
Phone (704) 884-6446

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689793119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 TYVOLA RD STE 307",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173515",
            "telephone_number": "704-884-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 TYVOLA RD STE 307",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173515",
            "telephone_number": "704-884-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION HEALTHCARE PROVIDER SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "SERVICES DIRECTOR",
        "authorized_official_telephone_number": "704-644-5331",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301550",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.