NPIMap

Organization Active NPI

Eye Vermont LLC

  • Optometrist
  • South Burlington, VT
National Provider Identifier
1902853559
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
315 Issued in VT
Legal business name
EYE VERMONT LLC
Practice address
100 Dorset St
Suite 25
South Burlington, VT 05403
Phone
(802) 863-3000
Fax
(802) 863-3001
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Authorized official

Name
Carly Schmidt
Title
Office Manager
Phone
(802) 863-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 315 VT Primary

Addresses

Primary practice location

100 Dorset St
Suite 25
South Burlington, VT 05403

Mailing address

100 Dorset St
Suite 25
South Burlington, VT 05403-6241
Phone (802) 863-3000

Other identifiers 3

IdentifierTypeStateIssuer
DF3986OtherVTMEDICARE RAILROAD
0VN3977MedicaidVT
EYEV00069292OtherBLUE SHIELD OF VT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180817002890 VT Part B Supplier - Clinic/Group Practice 2860741287 Receives reassigned benefits from 3 practitioners
Practice locations: South Burlington, VT

National Provider Directory

National Provider Directory

Locations

100 Dorset St
Ste 25
South Burlington, VT 05403
Phone (802) 863-3000

Practitioners & affiliated clinicians

Practitioners 5

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": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530057600000",
    "number": "1902853559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DORSET ST",
            "address_2": "SUITE 25",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036241",
            "telephone_number": "802-863-3000",
            "fax_number": "802-863-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DORSET ST",
            "address_2": "SUITE 25",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "05403",
            "telephone_number": "802-863-3000",
            "fax_number": "802-863-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE VERMONT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2018-06-27",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "CARLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "802-863-3000"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VT",
            "license": "315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DF3986",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN3977",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF VT",
            "identifier": "EYEV00069292",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.