Active NPI
Sports Vision Specialists LLC
- Sports Vision Optometrist
- Terre Haute, IN
National Provider Identifier
1700250628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Vision Optometrist
- License
- 18003213A
- Legal business name
- SPORTS VISION SPECIALISTS LLC
- Practice address
- 643 Ohio St
Terre Haute, IN 47807-3525 - Phone
- (812) 232-1000
- Fax
- (812) 232-1007
- NPI assigned
- Nov 16, 2015
- Last updated
- Sep 1, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amanda Elaine Judson, OD
- Title
- Owner
- Phone
- (812) 232-1000
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Vision Optometrist | 152WS0006X | 18003213A | IN | Primary |
Addresses
Primary practice location
643 Ohio St
Terre Haute, IN 47807-3525
Mailing address
643 Ohio St
Terre Haute, IN 47807-3525
Phone (812) 232-1000
National Provider Directory
National Provider DirectoryLocations
8174 N County Road 150 W
Brazil, IN 47834
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.
-
- Optometrist
- Terre Haute, IN
- NPI 1255367686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598918400000",
"number": "1700250628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "643 OHIO ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478073525",
"telephone_number": "812-232-1000",
"fax_number": "812-232-1007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "643 OHIO ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478073525",
"telephone_number": "812-232-1000",
"fax_number": "812-232-1007"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPORTS VISION SPECIALISTS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-11-16",
"last_updated": "2020-09-01",
"certification_date": "2020-09-01",
"status": "A",
"authorized_official_last_name": "JUDSON",
"authorized_official_first_name": "AMANDA",
"authorized_official_middle_name": "ELAINE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "812-232-1000",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152WS0006X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Sports Vision",
"state": "IN",
"license": "18003213A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.