Vision Source of Wenatchee, PS

Primary specialty

OptometristTaxonomy code 152W00000X

License

1494 Issued in WA

Legal business name

VISION SOURCE OF WENATCHEE, PS

Practice address

1190 5TH St
Wenatchee, WA 98801-1825

Phone

(509) 662-9671

Fax

(509) 662-9672

NPI assigned

Jan 1, 2007

Last updated

Mar 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicholas Allen Donaghey, ODNPI 1063854479

Title

Vice President

Phone

(509) 662-9671

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Vision Source of Wenatchee, PS

  dba Vision Source of Chelan

  • Optometrist
  • Chelan, WA
  • NPI 1083454334

  O20060201000033

  Same enrollment
• Vision Source of Wenatchee, PS

  dba Leavenworth Vision Source

  • Optometrist
  • Leavenworth, WA
  • NPI 1538219787

  O20060201000033

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: jasbarnes@visionsourcewen.eyefinity-direct.com
• Direct secure messaging: jrenardod@visionsourcewen.eyefinity-direct.com
• Direct secure messaging: ndonaghey@visionsourcewen.eyefinity-direct.com
• Direct secure messaging: skoch@visionsourcewen.eyefinity-direct.com

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas Allen Donaghey, O.D.

  • Optometrist
  • Wenatchee, WA
  • NPI 1063854479
  Medicare reassignment Care Compare group NPD Authorized official
• Jason D Barnes, O.D.

  • Optometrist
  • Wenatchee, WA
  • NPI 1306151287
  Medicare reassignment Care Compare group NPD
• Amanda Joy Donabauer, O.D.

  • Optometrist
  • East Wenatchee, WA
  • NPI 1407102452
  Medicare reassignment Care Compare group NPD
• Sarah Krauss, OD

  • Optometrist
  • Wenatchee, WA
  • NPI 1407543424
  Medicare reassignment Care Compare group NPD
• Jennifer Larie Renard, OD

  • Optometrist
  • Wenatchee, WA
  • NPI 1699183061
  Medicare reassignment Care Compare group NPD
• Nikita Katoozi, OD

  • Optometrist
  • Casper, WY
  • NPI 1083106843

  WA

  Medicare reassignment Care Compare group NPD
• Steven D Koch, O.D.

  • Optometrist
  • Wenatchee, WA
  • NPI 1467481770
  NPD

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679702400000",
    "number": "1023175163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 5TH ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011825",
            "telephone_number": "509-662-9671",
            "fax_number": "509-662-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 5TH ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011825",
            "telephone_number": "509-662-9671",
            "fax_number": "509-662-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SOURCE OF WENATCHEE, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-01",
        "last_updated": "2023-03-25",
        "certification_date": "2023-03-25",
        "status": "A",
        "authorized_official_last_name": "DONAGHEY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "509-662-9671",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030914",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joey Edith Victoria-Lopez, PA-C
• Luke Vierthaler, MD
• Jose Antonio Villa-Casillas, B.A.
• Sandra M Villarreal
• Vision Clinic Inc
• Vista Optometric
• Vitality Physio PLLC
• Heather Vanessa Voldberg, MCI
• Roger J Volkmann, MD
• Grace Marie Volsen, MPT

• Optometrist in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.