Vivid Vision II

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

VIVID VISION II

Practice address

4066 Percheron LN
Snellville, GA 30039-2780

Phone

(404) 202-5219

Fax

(770) 648-6289

NPI assigned

Mar 20, 2015

Last updated

Jan 25, 2016By 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

Mrs. Shari BlakeNPI 1063318491

Title

Owner

Phone

(404) 202-5219

Specialties & licenses 1

Addresses

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.

• Shari Blake

  • Case Manager/Care Coordinator
  • Loganville, GA
  • NPI 1063318491
  Authorized official Same address or phone

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1871987404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4066 PERCHERON LN",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300392780",
            "telephone_number": "404-202-5219",
            "fax_number": "770-648-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4066 PERCHERON LN",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300392780",
            "telephone_number": "404-202-5219",
            "fax_number": "770-648-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID VISION II",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-20",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "SHARI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-202-5219",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Villanueva, C.R.N.A.
• Virtuous Hospice Care
• Vision Institute Optical, LLC
• Vitality Care LLC
• Vivasalud Clinic 1 LLC
• Elizabeth Vo, PHARMD
• Shonda Middleton Waddell, P.A.
• Shaquinna Wadley, RBT
• Russell G Wagner, M.D.
• Amy J Waite, MA/CCC-SLP

• Case Management Agency in Snellville, GA
• Providers in Snellville, GA by specialty
• Case Management Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.