World Wide Vision Therapy Centers, L.L.C.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

4901002693 Issued in MI

Legal business name

WORLD WIDE VISION THERAPY CENTERS, L.L.C.

Doing business as

Wow Vision Therapy

Practice address

3152 Peregrine Dr NE
Suite C205
Grand Rapids, MI 49525-9723

Phone

(616) 447-1444

Fax

(616) 447-1445

NPI assigned

May 20, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Dan L Fortenbacher, O.D.NPI 1760519946

Title

Owner

Phone

(269) 983-3309

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• WOW VISION THERAPY Doing business as

Locations

Practitioners 2

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

• Dan Lee Fortenbacher, O.D.

  • Vision Therapy Optometrist
  • Saint Joseph, MI
  • NPI 1760519946
  NPD (past) Authorized official
• Kelsey Starman

  • Pediatric Optometrist
  • Warrensburg, MO
  • NPI 1265997522

  Vision Therapy

  NPD (past)

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1801275193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 PEREGRINE DR NE",
            "address_2": "SUITE C205",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259723",
            "telephone_number": "616-447-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 PEREGRINE DR NE",
            "address_2": "SUITE C205",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259723",
            "telephone_number": "616-447-1444",
            "fax_number": "616-447-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORLD WIDE VISION THERAPY CENTERS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "FORTENBACHER",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-983-3309",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002693",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "MI",
            "license": "4901002693",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "MI",
            "license": "4901002693",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "MI",
            "license": "4901004791",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "MI",
            "license": "4901004454",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "900A165280",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOW VISION THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lacy J Worden, PHARM D.
• Work-Fit LLC
• Heidi Lyn Workman, LMSW
• Joseph John-Karl Workman, MT
• Miranda Workman
• Milinda Worley, LLPC
• Thomas Worm, LMSW
• Todd Allen Wormmeester, PHD
• Hailey Worstman, MD
• Cathy Lynn Worthem, MSW, LMSW

• Vision Therapy Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Vision Therapy Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.