Behavioral Vision, LTD.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

046009482 Issued in IL

Legal business name

BEHAVIORAL VISION, LTD.

Practice address

820 E Terra Cotta Ave
Suite 256
Crystal Lake, IL 60014-3649

Phone

(815) 455-2800

Fax

(815) 455-2801

NPI assigned

Jul 28, 2010

Last updated

Sep 12, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Carrie Spencer Sypherd, O.D.NPI 1992756290

Title

Owner

Phone

(815) 455-2800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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.

• Carrie Sypherd, O.D.

  • Optometrist
  • Crystal Lake, IL
  • NPI 1992756290
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315785600000",
    "number": "1851605240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE",
            "address_2": "SUITE 256",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143649",
            "telephone_number": "815-455-2800",
            "fax_number": "815-455-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE",
            "address_2": "SUITE 256",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143649",
            "telephone_number": "815-455-2800",
            "fax_number": "815-455-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL VISION, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-28",
        "last_updated": "2011-09-12",
        "status": "A",
        "authorized_official_last_name": "SYPHERD",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "SPENCER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-455-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "IL",
            "license": "046009482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vision Therapy Optometrist in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Vision Therapy Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.