NPIMap

Organization Active NPI

Silverton Eye Care LLC

  • Optometrist
  • Silverton, OR
National Provider Identifier
1003215807
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3228ATI Issued in OR
Legal business name
SILVERTON EYE CARE LLC
Practice address
114 W Main St
Silverton, OR 97381-2019
Phone
(503) 873-2788
NPI assigned
Aug 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Keirsten Danee Eagles, O.D.NPI 1881893626
Title
Owner
Phone
(503) 881-5486

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 3228ATI OR Primary
Pediatric OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WP0200X 3228ATI OR
Sports Vision OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WS0006X 3228ATI OR
Vision Therapy OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WV0400X 3228ATI OR

Addresses

Primary practice location

114 W Main St
Silverton, OR 97381-2019

Mailing address

114 W Main St
Silverton, OR 97381-2019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141002000039 OR Part B Supplier - Clinic/Group Practice 8123248788 Receives reassigned benefits from 3 practitioners
Practice locations: Silverton, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1003215807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W MAIN ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973812019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W MAIN ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973812019",
            "telephone_number": "503-873-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERTON EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "EAGLES",
        "authorized_official_first_name": "KEIRSTEN",
        "authorized_official_middle_name": "DANEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-881-5486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3228ATI",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "OR",
            "license": "3228ATI",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "OR",
            "license": "3228ATI",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "OR",
            "license": "3228ATI",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.