VICKSBURG OPTOMETRY LLC NPI 1013689819

NPI Record

The following NPI record includes the field values provided by the NPPES as well as the field definition as published in the Federal Register. The complete NPI record is also available for download in text, csv and xml formats.

Field Name Field Value Definition 1
NPI 1013689819 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Organization Name Legal Business Name VICKSBURG OPTOMETRY LLC The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Provider First Line Business Practice Location Address 800 E CHICAGO ST The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Provider Business Practice Location Address City Name COLDWATER The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Business Practice Location Address State Name MI The city name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 490362055 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 5172782809 The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 5172782199 The first name of the provider, if the provider is an individual.
Provider Enumeration Date 9/30/2021 The first name of the provider, if the provider is an individual.
Last Update Date 9/30/2021 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Authorized Official Last Name GARCIA The 10-position telephone number of the authorized official.
Authorized Official First Name MARIA The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Authorized Official Middle Name LYN-SHOOP The name of the organization provider. If the provider is an organization, this is the legal business name.
Authorized Official Title or Position OPTOMETRIST OWNER The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Authorized Official Telephone Number 2696490103 The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1 152W00000X Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Healthcare Provider Primary Taxonomy Switch 1 Y The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Is Organization Subpart N The telephone number associated with the location address of the provider being identified.
Authorized Official Credential Text OD The fax number associated with the location address of the provider being identified.
Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
NPI Certification Date 9/30/2021 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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