MEDICARE: VISION PROFESSIONALS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1164187274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION PROFESSIONALS

Provider Business Mailing Address
First Line	:	3814 BROADWAY
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2234
Country	:	US
Telephone Number	:	614-871-2080
Fax Number	:	614-846-8577

Provider Business Practice Location Address
First Line	:	3814 BROADWAY
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2234
Country	:	US
Telephone Number	:	614-871-2080
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	CHRIS A SMILEY
Credential	:	OD
Telephone Number	:	614-880-2020

Provider Enumeration Date	:	11/03/2021
Last Update Date	:	05/05/2026

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Directions to “VISION PROFESSIONALS ” Practice Location

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