Marengo Vision Center, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

060009322 Issued in IL

Legal business name

MARENGO VISION CENTER, P.C.

Practice address

205 N State St
Marengo, IL 60152-2239

Phone

(815) 568-6508

NPI assigned

Jul 5, 2006

Last updated

Aug 23, 2010By 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

Dr. Michael W. ThomasNPI 1679539993

Title

President

Phone

(815) 568-6508

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Marengo Vision Center, P.C.

  dba Harvard Family Eye Care

  • Optometrist
  • Harvard, IL
  • NPI 1396940938

  O20060724000159

  Same enrollment

Locations

Practitioners 4

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.

• Michael William Thomas, O.D.

  • Optometrist
  • Marengo, IL
  • NPI 1679539993
  NPD Authorized official
• Jeffrey T Caron, P.C.

  • Optometrist
  • Genoa, IL
  • NPI 1194701490
  NPD
• Javier Ramiro Rodriguez, OD

  • Optometrist
  • Marengo, IL
  • NPI 1275056236
  NPD
• Jon W Russell, O.D.

  • Optometrist
  • Marengo, IL
  • NPI 1831177088
  NPD

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282521600000",
    "number": "1992736276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N STATE ST",
            "city": "MARENGO",
            "state": "IL",
            "postal_code": "601522239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N STATE ST",
            "city": "MARENGO",
            "state": "IL",
            "postal_code": "601522239",
            "telephone_number": "815-568-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARENGO VISION CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-08-23",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-568-6508",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "060009322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marengo Dental
• Marengo Occupational Therapy Services, Inc
• Marengo Physical Therapy, Inc. (CORA Physical Therapy - Marengo)
• Marengo Rescue Squad District
• Marengo School District 154
• Marengo-Union Elementary Consolidated School District 165
• Marnul Eye Care, P.C.
• Paul Allen Marnul, O.D.
• Madeline Meidl
• Stacey Moorhouse

• Optometrist in Marengo, IL
• Providers in Marengo, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.