John Reidy O.D.,P.S.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1612 Issued in WA

Legal business name

JOHN REIDY O.D.,P.S.

Practice address

5601 E Sprague Ave
Spokane Valley, WA 99212-0826

Phone

(509) 842-0001

NPI assigned

Apr 18, 2008

Organization subpart

No

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

Authorized official

Name

John Reidy, O.D.

Title

President

Phone

(509) 842-0001

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1043484116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992120826",
            "telephone_number": "509-842-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992120826",
            "telephone_number": "509-842-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN REIDY O.D.,P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "REIDY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-842-0001",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "8805615",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.