Organization Active NPI

Clio Vision Services Inc

  • Optometrist
  • Clio, MI
National Provider Identifier
1952432361
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002607 Issued in MI
Legal business name
CLIO VISION SERVICES INC
Practice address
2155 W Vienna Rd
Clio, MI 48420-1757
Phone
(810) 686-4240
Fax
(810) 686-1682
NPI assigned
Mar 8, 2007
Last updated
Apr 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Mr. Martin Quillen
Title
President
Phone
(810) 686-8372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002607 MI Primary

Addresses

Primary practice location

2155 W Vienna Rd
Clio, MI 48420-1757

Mailing address

2155 W Vienna Rd
Clio, MI 48420-1261
Phone (810) 686-8372

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000738 MI Part B Supplier - Clinic/Group Practice 5092607804 Receives reassigned benefits from 2 practitioners
Practice locations: Clio, MI

National Provider Directory

National Provider Directory

Locations

2155 W Vienna Rd
Clio, MI 48420
Phone (810) 686-4240

Practitioners & affiliated clinicians

Practitioners 3

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1952432361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 W VIENNA RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484201261",
            "telephone_number": "810-686-8372",
            "fax_number": "810-686-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 W VIENNA RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484201757",
            "telephone_number": "810-686-4240",
            "fax_number": "810-686-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIO VISION SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "QUILLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-686-8372",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clio, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.