Vision Academy SF- an Optometric Corp.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

Legal business name

VISION ACADEMY SF- AN OPTOMETRIC CORP.

Practice address

361 3Rd St Ste C
San Rafael, CA 94901-3580

Phone

(415) 459-2020

Fax

(415) 459-2021

NPI assigned

Jun 17, 2021

Organization subpart

No

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

Authorized official

Name

Jeremy Shumaker, ODNPI 1730389347

Title

Owner

Phone

(510) 928-4986

Specialties & licenses 6

Addresses

Other names 1

• Rising Star Optometry Doing business as

Locations

Practitioners 1

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

• Jeremy Ross Shumaker, O.D.

  • Corneal and Contact Management Optometrist
  • San Rafael, CA
  • NPI 1730389347
  NPD Authorized official

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1821666546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 3RD ST STE C",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013580",
            "telephone_number": "415-459-2020",
            "fax_number": "415-459-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 3RD ST STE C",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013580",
            "telephone_number": "415-459-2020",
            "fax_number": "415-459-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941105419",
            "country_code": "US",
            "telephone_number": "415-459-2020",
            "fax_number": "415-459-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISION ACADEMY SF- AN OPTOMETRIC CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "SHUMAKER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-928-4986",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Occupational Vision",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rising Star Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katrina Villena
• Rosa Elena Vince, D.C.
• Colleen Christine Vincent, COTA
• Nita Jean Vincent
• Simran K Virdee
• Visionary Healthcare
• Jazmine-Ciara Bayangos Visperas
• Amanda Vissering, LPCC, LMHC, PPSC
• Anne Marie Vitale, PHD
• Alisha Jean Vogt, LMFT

• Vision Therapy Optometrist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Vision Therapy Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.