Vermillion Vision Clinic, PC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

578 Issued in SD

Legal business name

VERMILLION VISION CLINIC, PC

Practice address

120 W Main St
Vermillion, SD 57069-3036

Phone

(605) 624-4291

Fax

(605) 624-6822

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Amy M Dejong, O.D.

Title

President

Phone

(605) 624-4291

Specialties & licenses 1

Addresses

Other identifiers 10

Locations

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394755200000",
    "number": "1861694812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570693036",
            "telephone_number": "605-624-4291",
            "fax_number": "605-624-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570693036",
            "telephone_number": "605-624-4291",
            "fax_number": "605-624-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMILLION VISION CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2014-03-14",
        "status": "A",
        "authorized_official_last_name": "DEJONG",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-624-4291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "SD",
            "license": "578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVERA HEALTH",
            "identifier": "11321",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE GROUP",
            "identifier": "9219420",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "OP2175",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANFORD HEALTH GROUP",
            "identifier": "32866",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9200863",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH CARE OF IOWA",
            "identifier": "399493",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE, AETNA, CIGNA",
            "identifier": "238521",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP",
            "identifier": "4995791",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA UNITED HEALTHCARE",
            "identifier": "2100851",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "6056244291",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric John Vargas Vanderlee
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• Ryan Vinzant
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• Victoria L Walker, M.D.
• Walmart Inc.
• Allison Walsh, LPC

• Corneal and Contact Management Optometrist in Vermillion, SD
• Providers in Vermillion, SD by specialty
• Corneal and Contact Management Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.