NPIMap

Organization Active NPI

Visionary Enterprises Inc

  • Prosthetic/Orthotic Supplier
  • Indianapolis, IN
National Provider Identifier
1720284748
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
VISIONARY ENTERPRISES INC
Practice address
7120 Clearvista Dr Ste 1000
Attn: Figleaf Boutique
Indianapolis, IN 46256-1672
Phone
(317) 621-5323
Fax
(317) 621-3447
NPI assigned
Jun 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Authorized official

Name
Mr. Mike Hogan
Title
SVP
Phone
(317) 621-7409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

7120 Clearvista Dr Ste 1000
Attn: Figleaf Boutique
Indianapolis, IN 46256-1672

Mailing address

6626 E 75TH St Ste 200
Attn L Pendleton
Indianapolis, IN 46250-2855
Phone (317) 621-7543

Other identifiers 2

IdentifierTypeStateIssuer
201011550AMedicaidIN
000000695887OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110426000781 IN DME Supplier - Medical Supply Company 0446154215 Practice locations: Indianapolis, IN

Other NPIs with the same Medicare PAC ID 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Visionary Enterprises Inc7120 Clearvista Dr, Indianapolis, IN 46256-1672(317) 621-5323 Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Mar 8, 1992

National Provider Directory

National Provider Directory
Tax ID family
Visionary Enterprises Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7979 N Shadeland Ave
Ste 110
Indianapolis, IN 46250
Phone (317) 621-0485

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1720284748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 200",
            "address_2": "ATTN L PENDLETON",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502855",
            "telephone_number": "317-621-7543",
            "fax_number": "317-621-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 CLEARVISTA DR STE 1000",
            "address_2": "ATTN: FIGLEAF BOUTIQUE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561672",
            "telephone_number": "317-621-5323",
            "fax_number": "317-621-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "317-621-7409",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201011550A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000695887",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.