Watertown Vision, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WATERTOWN VISION, LLC

Practice address

1640 S Church St
Watertown, WI 53094-6406

Phone

(920) 390-2971

Fax

(920) 390-2974

NPI assigned

Sep 27, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Jason Procto

Title

Owner/Operator

Phone

(414) 810-8003

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Bjork, O.D.

  • Optometrist
  • Oconomowoc, WI
  • NPI 1487726535
  Medicare reassignment Care Compare group NPD
• Macie Brahm, OD

  • Optometrist
  • Oconomowoc, WI
  • NPI 1831931914
  Medicare reassignment Care Compare group NPD
• Desiree Monik Herron, O.D.

  • Optometrist
  • Watertown, WI
  • NPI 1245568682
  Medicare reassignment Care Compare group NPD
• Erik R Bjork, O.D

  • Optometrist
  • Oconomowoc, WI
  • NPI 1962453589
  Medicare reassignment NPD
• Elyse Bruns, O.D.

  • Optometrist
  • Waukesha, WI
  • NPI 1407204506
  Medicare reassignment NPD

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1780935957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 S CHURCH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946406",
            "telephone_number": "920-390-2971",
            "fax_number": "920-390-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 S CHURCH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946406",
            "telephone_number": "920-390-2971",
            "fax_number": "920-390-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN VISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "PROCTO",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "414-810-8003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Watertown Regional Medical Center, Inc
• Watertown Regional Medical Center, Inc
• Watertown Regional Medical Center, Inc
• Watertown Unified School District
• Watertown Urology, S.C.
• Jessica Ann Waterworth, DC
• Rachel Weeden, PTA
• Bryce Wegner
• Mary Lee Wegner, LPN
• Bradley H Wehking, D.C.

• Optometrist in Watertown, WI
• Providers in Watertown, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.