Vision Street Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2000160791 Issued in MO

Legal business name

VISION STREET EYE CARE LLC

Doing business as

Sago and Street Eye Care

Practice address

102 Westmount Dr.
Farmington, MO 63640-0829

Phone

(573) 756-3170

Fax

(573) 756-0173

NPI assigned

Nov 28, 2006

Last updated

Jun 12, 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

Dr. Jason T Street, ODNPI 1467511105

Title

Owner Optometrist

Phone

(573) 756-3170

Specialties & licenses 3

Addresses

Other names 2

• Sago and Street Eye Care Doing business as
• Sago & Street Eyecare Former legal business name

Medicare fee-for-service enrollment

Enrolled in MO2 enrollments

Enrollment records 2

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

Locations

Practitioners 2

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.

• Jason Travers Street, OD

  • Optometrist
  • Farmington, MO
  • NPI 1467511105
  Medicare reassignment Care Compare group NPD Authorized official
• Kennon Cox, OD

  • Optometrist
  • Carbondale, IL
  • NPI 1558914150

  MO

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1770659864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WESTMOUNT DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402970",
            "telephone_number": "573-756-3170",
            "fax_number": "573-756-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WESTMOUNT DR.",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636400829",
            "telephone_number": "573-756-3170",
            "fax_number": "573-756-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION STREET EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "573-756-3170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02599",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2000160791",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sago and Street Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sago and Street Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sago & Street Eyecare",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sekhar Vangala, M.D.
• Scott Allen Vanness, D.O.
• Vicky L Winick (New Horizons RCF II)
• Amy B Vinson, PLPC
• Jessica Lynn Vinyard, PTA
• Vna Homecare, Inc. (Tip Hospice)
• Vna Homecare, Inc. (VNA-Tip HomeCare)
• James Nolan Wade II
• Maredith Leann Wade, MSE
• Steven Thomas Duel Wade, AU.D.

• Optometrist in Farmington, MO
• Providers in Farmington, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.