Organization Active NPI

Newberry Vision Center, PLLC

  • Optometrist
  • McKinney, TX
National Provider Identifier
1841609187
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5516TG Issued in TX
Legal business name
NEWBERRY VISION CENTER, PLLC
Practice address
1716 W Virginia St
McKinney, TX 75069-7864
Phone
(972) 562-0101
Fax
(972) 562-0406
NPI assigned
Aug 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Angela M AhrensNPI 1629074612
Title
OD
Phone
(972) 562-0101

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: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5516TG TX Primary

Addresses

Primary practice location

1716 W Virginia St
McKinney, TX 75069-7864

Mailing address

1716 W Virginia St
McKinney, TX 75069-7864
Phone (972) 562-0101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150205002174 TX Part B Supplier - Clinic/Group Practice 7911222328 Receives reassigned benefits from 5 practitioners
Practice locations: McKinney, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1841609187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 W VIRGINIA ST",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750697864",
            "telephone_number": "972-562-0101",
            "fax_number": "972-562-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 W VIRGINIA ST",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750697864",
            "telephone_number": "972-562-0101",
            "fax_number": "972-562-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERRY VISION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-12",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "AHRENS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "972-562-0101"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5516TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.