NPIMap

Organization Active NPI

Wisconsin Vision, Inc

  • Optometrist
  • Kokomo, IN
National Provider Identifier
1871631978
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WISCONSIN VISION, INC
Practice address
2030 S Reed Rd
Kokomo, IN 46902-1905
Phone
(765) 455-1644
Fax
(765) 455-1688
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Mr. Darren Thomas Horndasch
Title
President Ceo
Phone
(262) 432-2005

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X

Addresses

Primary practice location

2030 S Reed Rd
Kokomo, IN 46902-1905

Mailing address

16800 West Cleveland Ave
New Berlin, WI 53151-3533
Phone (262) 432-2005

Other names 1

  • Heartland Vision Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4648 S Scatterfield Rd
Anderson, IN 46013
Phone (765) 644-0506

Practitioners & affiliated clinicians

Practitioners 2

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": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1871631978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 WEST CLEVELAND AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531513533",
            "telephone_number": "262-432-2005",
            "fax_number": "262-432-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 S REED RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469021905",
            "telephone_number": "765-455-1644",
            "fax_number": "765-455-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN VISION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "HORNDASCH",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "262-432-2005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heartland Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.