Virginia Eyecare Clinic, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

VIRGINIA EYECARE CLINIC, LLC

Practice address

1193 Plaza Dr
Grundy, VA 24614-6780

Phone

(276) 935-4558

Fax

(276) 935-2993

NPI assigned

Jul 28, 2006

Last updated

Jan 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Joy Umlandt, ODNPI 1720217854

Title

Owner/Optometrist

Phone

(276) 935-2292

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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.

• Amanda Joy Umlandt, O.D.

  • Optometrist
  • Grundy, VA
  • NPI 1720217854
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673740800000",
    "number": "1710991708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1193 PLAZA DR",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246146780",
            "telephone_number": "276-935-2292",
            "fax_number": "276-935-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 PLAZA DR",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246146780",
            "telephone_number": "276-935-4558",
            "fax_number": "276-935-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA EYECARE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-01-15",
        "certification_date": "2023-01-15",
        "status": "A",
        "authorized_official_last_name": "UMLANDT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "276-935-2292",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601002211",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009237348",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9200061001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "143512",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ultra Health LLC (Town Center)
• Amanda Joy Umlandt, O.D.
• Craig Dwayne Viers
• Nancy Michele Viers, RPH
• Virginia Department of Health (Buchanan County Health Department)
• Virginia Medical and Respiratory Equipment, Inc.
• Tanner Keith Wagner
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3303)
• Walgreen Co (Walgreens #17306)
• Marsha Danette Whited, FNP-BC

• Optometrist in Grundy, VA
• Providers in Grundy, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2023; 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.