NPIMap

Organization Active NPI

Advanced Vision Care, LLC

  • Optometrist
  • Minocqua, WI
National Provider Identifier
1922138205
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2838-035 Issued in WI
Legal business name
ADVANCED VISION CARE, LLC
Practice address
9815 State Highway 70
Suite 102
Minocqua, WI 54548-9769
Phone
(715) 358-3937
Fax
(715) 358-7677
NPI assigned
Mar 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. C. Gregory Vickers, ODNPI 1801827456
Title
Owner
Phone
(715) 358-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2838-035 WI Primary

Addresses

Primary practice location

9815 State Highway 70
Suite 102
Minocqua, WI 54548-9769

Mailing address

9815 State Highway 70
Suite 102
Minocqua, WI 54548-9769
Phone (715) 358-3937

National Provider Directory

National Provider Directory

Locations

9815 State Highway 70
#102
Minocqua, WI 54548
Phone (715) 358-3937

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922138205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9815 STATE HIGHWAY 70",
            "address_2": "SUITE 102",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489769",
            "telephone_number": "715-358-3937",
            "fax_number": "715-358-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 STATE HIGHWAY 70",
            "address_2": "SUITE 102",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489769",
            "telephone_number": "715-358-3937",
            "fax_number": "715-358-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VISION CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VICKERS",
        "authorized_official_first_name": "C.",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-358-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2838-035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minocqua, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.