Active NPI
Michael Ray Davis, LDO
- Optician
- Yakima, WA
National Provider Identifier
1023261435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO 00001859
- Practice address
- 506 N 40TH Ave
Suite 101
Yakima, WA 98908-4318 - Phone
- (509) 966-4735
- Fax
- (509) 966-4755
- NPI assigned
- Oct 29, 2008
- Last updated
- Sep 24, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO 00001859 | WA | Primary |
Addresses
Primary practice location
506 N 40TH Ave
Suite 101
Yakima, WA 98908-4318
Mailing address
506 N 40TH Ave
Suite 101
Yakima, WA 98908-4318
Phone (509) 966-4735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO 00001859 | WA | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yakima Eye Care, Inc., P.S. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmology Physician
- Yakima, WA
- NPI 1538483797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285286400000",
"number": "1023261435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 N 40TH AVE",
"address_2": "SUITE 101",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989084318",
"telephone_number": "509-966-4735",
"fax_number": "509-966-4755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 N 40TH AVE",
"address_2": "SUITE 101",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989084318",
"telephone_number": "509-966-4735",
"fax_number": "509-966-4755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MICHAEL",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-29",
"last_updated": "2010-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "WA",
"license": "DO 00001859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.