Organization Active NPI

Family Vision Center of Sarasota LLC

  • Optometrist
  • Sarasota, FL
National Provider Identifier
1720805237
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY VISION CENTER OF SARASOTA LLC
Practice address
3900 Clark Rd
Suite P-1
Sarasota, FL 34233-2379
Phone
(941) 926-2020
Fax
(941) 926-2021
NPI assigned
Sep 25, 2024
Last updated
Oct 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Derek Richardson, ODNPI 1477809697
Title
Authorized Representative
Phone
(941) 926-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

3900 Clark Rd
Suite P-1
Sarasota, FL 34233-2379

Mailing address

3900 Clark Rd
Suite P-1
Sarasota, FL 34233-2379
Phone (941) 926-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241216000614 FL Part B Supplier - Clinic/Group Practice 9830625763 Receives reassigned benefits from 3 practitioners
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Locations

3900 Clark Rd
#1
Sarasota, FL 34233

3900 Clark Rd
Ste P1
Sarasota, FL 34233
Phone (941) 525-8497

Practitioners & affiliated clinicians

Practitioners 3

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": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1720805237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 CLARK RD",
            "address_2": "SUITE P-1",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332379",
            "telephone_number": "941-926-2020",
            "fax_number": "941-926-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CLARK RD",
            "address_2": "SUITE P-1",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332379",
            "telephone_number": "941-926-2020",
            "fax_number": "941-926-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY VISION CENTER OF SARASOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "941-926-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.