STATELINE VISION CENTER LLC


Address: 250 N 18th Ave Ste 105, Monroe, WI 53566-1482
Phone: 9202163133

STATELINE VISION CENTER LLC (NPI# 1104219039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104219039
Entity Type Organization
Organization Name STATELINE VISION CENTER LLC
Practice Address 250 N 18th Ave Ste 105
Monroe
WI 53566-1482
Practice Telephone 9202163133
Mailing Telephone 6083257200
Enumeration Date 2015-03-17
Last Update Date 2020-09-16
Authorized Official Name ANDREW M JOSEPHS (SOLE PROPRIETOR)
Authorized Official Telephone 6083257200
Authorized Official Credential O.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 152W00000X Optometrist 3082 WI Eye and Vision Services Providers

Office Location

Street Address 250 N 18TH AVE STE 105
City MONROE
State WI
Zip Code 53566-1482

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548752967 Mariah Mohns Occupational Therapy Assistant N3150 Wi- 81, Monroe, WI 53566 2018-06-01
1811414907 Yelena Gapchenko Pharmacist 515 22nd St., Monroe, WY 53566 2017-08-29
1508306283 Hilary Domke Occupational Therapist N3150 Wi-81, Monroe, WI 53566 2017-03-01
1699132332 Lisa Marty Social Worker N3152 Wi-81, Monroe, WI 53566 2016-01-26
1518223148 Lauren Nibler Craddock Dermatology 412 18th Ave, Monroe, WI 53566 2012-04-09
1033482799 Amber Gatdula Physical Therapy Assistant 2628 14th Street, Monroe, WI 53566 2012-02-10
1629361043 Tammy Noble Licensed Practical Nurse N2546 Ullom Rd., Monroe, WI 53566 2011-05-18
1023331683 Kristine Hudson Registered Nurse 1110 11th Street, Monroe, WI 53566 2010-03-10
1306005012 Rosemary Ann Graham Registered Nurse 2413 5th Ave, Monroe, WI 53566 2008-06-06
1174702559 Kelly Jo Jenson Chiropractor 1518 11th Street, Suite 1-2, Monroe, WI 53566 2007-11-01
Find all providers in zip 53566

Taxonomy Information

Taxonomy Code 152W00000X
Grouping Eye and Vision Services Providers
Classification Optometrist

Taxonomy Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881178234 Kasayla Fe Kuzmic Optometrist 1253 N Raisinville Rd, Monroe, MI 48162-9666 2018-09-21
1639606700 Ashley M O'dwyer Optometrist 750 Stewart Rd Ste 2, Monroe, MI 48162-4279 2017-05-18
1235539255 Envision Eye Care Inc Optometrist 1 Preshburg Blvd, Unit 001, Monroe, NY 10950 2014-08-27
1700207511 Sita Patel Optometrist 1007 Skyway Dr Ste A, Monroe, NC 28110-3051 2013-12-20
1740541796 Whitney Presto White Optometrist 907 Regents Park Dr, Monroe, MI 48161-9761 2012-06-06
1386811404 Idaho Falls Vision Center Chartered Optometrist 20231 209th Ave Se, Monroe, WA 98272-9371 2008-05-08
1700059656 Dr. Michael J. Haynes A Professional Corporation Optometrist 2808 Forsythe Avenue, Monroe, LA 71201-3008 2008-04-10
1609065077 Jason B Berkebile Optometrist 1976 Wellness Blvd, Monroe, NC 28110 2007-10-22
1871788562 P-cor, LLC Optometrist 504 N Telegraph Rd, Monroe, MI 48162 2007-09-06
1861613424 William M Bateman Jr. Optometrist 1208 North 18th Street, Monroe, LA 71201-5430 2007-05-01
Find all providers in MONROE

Competitor

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City MONROE
Zip Code 53566

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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