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DELAWARE VISION ACADEMY LLC NPI 1518092659


NPI Information

NPI: 1518092659
Provider Name: DELAWARE VISION ACADEMY LLC
Classification: Optometrist - 152WV0400X
Entity Type: Organization

Specialization: Vision Therapy

CLIA Number: 08D2145137

Address:
3105 LIMESTONE RD
SUITE 102
WILMINGTON, DE
ZIP 19808
Phone: (302) 998-1395
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DELAWARE VISION ACADEMY LLC is a vision therapy optometrist in Wilmington, DE. The provider is optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. DELAWARE VISION ACADEMY LLC NPI is 1518092659. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3105 LIMESTONE RD
SUITE 102
WILMINGTON, DE
ZIP 19808-147
Phone: (302) 998-1395
Fax: (302) 998-6784

The provider's authorized official is Don David Blackburn .
The authorized official title is President and has the following contact phone number (302) 998-1395.

The CLIA number assigned to this NPI record is 08D2145137 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/22/2007 and was last updated on 2/27/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristI3-0001218DELAWARENo
2152WP0200XOptometristPediatricsI3-0001218DELAWARENo
3152WS0006XOptometristSports VisionI3-0001218DELAWARENo
4156FX1800XTechnician/TechnologistOpticianI3-0001218DELAWARENo
5152WV0400XOptometristVision TherapyI3-0001218DELAWAREYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERDELAWAREBCBS
2258125OTHERDELAWARECOVENTRY
3U65945MEDICARE UPINDELAWARE
4G01597MEDICARE PINDELAWARE

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: 4/28/2024

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