NPIMap

Organization Active NPI

20-20 Visions LLC

  • Optometrist
  • Plymouth, WI
National Provider Identifier
1821139932
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
WI2028 Issued in WI
Legal business name
20-20 VISIONS LLC
Practice address
100 Carr Road
Plymouth, WI 53073-0600
Phone
(920) 893-3937
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dr. Sharon R Roberts, O.D.
Title
Owner
Phone
(920) 893-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X WI2028 WI Primary

Addresses

Primary practice location

100 Carr Road
Plymouth, WI 53073-0600

Mailing address

100 Carr Road
PO Box 600
Plymouth, WI 53073-0600
Phone (920) 893-3937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419000546 WI Part B Supplier - Clinic/Group Practice 0749275782 Receives reassigned benefits from 4 practitioners
Practice locations: Plymouth, WI

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
20- 20 Visions LLC100 Carr Rd, Plymouth, WI 53073-9500(920) 893-3937 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Apr 1, 2004

National Provider Directory

National Provider Directory

Locations

100 Carr Rd
Plymouth, WI 53073
Phone (920) 893-3937

Practitioners & affiliated clinicians

Practitioners 4

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": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1821139932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CARR ROAD",
            "address_2": "PO BOX 600",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530730600",
            "telephone_number": "920-893-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CARR ROAD",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530730600",
            "telephone_number": "920-893-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20-20 VISIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-893-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "WI2028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.