Organization Active NPI

Vision Center PC

  • Optometrist
  • Saint Joseph, MI
National Provider Identifier
1811018120
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISION CENTER PC
Doing business as
Robert L FLood OD PC
Practice address
2603 Niles Ave
Suite a
Saint Joseph, MI 49085-1954
Phone
(269) 408-8762
Fax
(269) 408-8764
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Authorized official

Name
Dr. Robert Flood, O.D.
Title
Owner
Phone
(269) 408-8762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2603 Niles Ave
Suite a
Saint Joseph, MI 49085-1954

Mailing address

2603 Niles Ave
Suite a
Saint Joseph, MI 49085-1954
Phone (269) 408-8762

Other identifiers 1

IdentifierTypeStateIssuer
0264260001OtherMIMEDICARE DME

Other names 1

  • Robert L FLood OD PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050405001115 MI Part B Supplier - Clinic/Group Practice 9133176761 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Joseph, MI

National Provider Directory

National Provider Directory

Locations

1380 E Napier Ave
Ste 1
Benton Harbor, MI 49022
Phone (269) 926-7277

2603 Niles Ave
Ste A
Saint Joseph, MI 49085
Phone (269) 408-8762

2603 Niles Ave
Saint Joseph, MI 49085

Practitioners & affiliated clinicians

Practitioners 3

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1811018120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 NILES AVE",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851954",
            "telephone_number": "269-408-8762",
            "fax_number": "269-408-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 NILES AVE",
            "address_2": "SUITE A",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851954",
            "telephone_number": "269-408-8762",
            "fax_number": "269-408-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "FLOOD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-408-8762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0264260001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert L FLood OD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.