Northern Sight Vision Clinic, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2911 Issued in WI

Legal business name

NORTHERN SIGHT VISION CLINIC, LLC

Practice address

318 N. 6TH Street
Tomahawk, WI 54487

Phone

(715) 453-3636

Fax

(715) 453-3011

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jessica J Stromberg, ODNPI 1932151677

Title

Optometrist / Co-Owner

Phone

(715) 453-3636

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Maley and Stromberg Eye Care, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northern Sight Vision Clinic, LLC

  • Optometrist
  • Phillips, WI
  • NPI 1295947109

  O20070621000277

  Same enrollment

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica J Stromberg, OD

  • Optometrist
  • Phillips, WI
  • NPI 1932151677
  NPD Authorized official
• Brittany S Lemke, O.D.

  • Optometrist
  • Tomahawk, WI
  • NPI 1851739635
  NPD
• Lauren Erica Treml, OD

  • Optometrist
  • Minocqua, WI
  • NPI 1508351099
  NPD
• Lawrence E Addison, O.D.

  • Optometrist
  • Weston, WI
  • NPI 1760794697
  NPD (past)
• Robert David Imm, DDS

  • General Practice Dentistry
  • Tomahawk, WI
  • NPI 1922174648
  NPD (past)
• Sandra Joy Maley, OD

  • Optometrist
  • Phillips, WI
  • NPI 1154353415
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1972723716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 N. 6TH STREET,",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "54487",
            "telephone_number": "715-453-3636",
            "fax_number": "715-453-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N. 6TH STREET",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "54487",
            "telephone_number": "715-453-3636",
            "fax_number": "715-453-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN SIGHT VISION CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "STROMBERG",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIST / CO-OWNER",
        "authorized_official_telephone_number": "715-453-3636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38564600",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38618200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maley and Stromberg Eye Care, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lori L. Mott, M.P.T.
• Kerry Newbury, PMHNP
• Emily Nicklaus, MS CCC-SLP
• Northbay Pharmacy, Inc
• Northern Chiropractic
• Northwoods Counseling LLC
• NSH Golden Age LLC
• NSH Riverview LLC
• Sara M Olson, NP
• Christopher Robert Orgeman, A.T.C.

• All providers in Tomahawk, WI
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.