NPIMap

Organization Active NPI

The Vision Center PA

  • Optometrist
  • Wiggins, MS
National Provider Identifier
1790962637
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
758 Issued in MS
Legal business name
THE VISION CENTER PA
Practice address
1113 Central Ave E
Wiggins, MS 39577
Phone
(601) 928-3914
Fax
(601) 928-2207
NPI assigned
Jan 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Mr. Gregory Dean Loose, ODNPI 1013096825
Title
President
Phone
(601) 928-3914

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
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 758 MS Primary

Addresses

Primary practice location

1113 Central Ave E
Wiggins, MS 39577

Mailing address

1113 Central Ave E
Wiggins, MS 39577
Phone (601) 928-3914

Other names 1

  • Gregory D Loose OD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080721000393 MS Part B Supplier - Clinic/Group Practice 6406929744 Receives reassigned benefits from 5 practitioners
Practice locations: Lucedale, MS; Wiggins, MS
O20100930099657 MS DME Supplier - Physician - Optometrist 6406929744 Practice locations: Wiggins, MS

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
The Vision Center PA1113 Central Ave E, Wiggins, MS 39577-9605(601) 928-3914 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jul 1, 2006

National Provider Directory

National Provider Directory

Locations

747 Winter St
Lucedale, MS 39452

727 Winter St
Lucedale, MS 39452
Phone (601) 947-2913

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1790962637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 CENTRAL AVE E",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "39577",
            "telephone_number": "601-928-3914",
            "fax_number": "601-928-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 CENTRAL AVE E",
            "city": "WIGGINS",
            "state": "MS",
            "postal_code": "39577",
            "telephone_number": "601-928-3914",
            "fax_number": "601-928-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VISION CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "LOOSE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-928-3914",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gregory D Loose OD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wiggins, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.