Healthcare Provider Details
I. General information
NPI: 1699576025
Provider Name (Legal Business Name): VILLAGE VISION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12082 SYCAMORE TRACE
PLAIN CITY OH
43064-4400
US
IV. Provider business mailing address
10380 HAZELNUT DR
PLAIN CITY OH
43064-2569
US
V. Phone/Fax
- Phone: 614-429-1101
- Fax: 614-633-1993
- Phone: 614-886-3388
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
STEPHANIE
SIMS
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 614-886-3388