Mount Vernon Vision Source PS Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003502 Issued in WA

Legal business name

MOUNT VERNON VISION SOURCE PS INC

Practice address

1616 N 18TH St Ste 104
Mount Vernon, WA 98273-2600

Phone

(360) 424-4181

Fax

(360) 424-6414

NPI assigned

Jul 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tod W Jones, O.D.NPI 1235200429

Title

Owner

Phone

(360) 424-4181

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 4

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

• Tod W Jones, O.D.

  • Optometrist
  • Mount Vernon, WA
  • NPI 1235200429
  Medicare reassignment Care Compare group Authorized official
• Rajveer Singh Minhas, O.D.

  • Optometrist
  • Mount Vernon, WA
  • NPI 1538427851
  Medicare reassignment Care Compare group NPD
• Kenneth L White, OD

  • Optometrist
  • Gig Harbor, WA
  • NPI 1003976358
  NPD (past)
• Ramandeep K Takher, O.D.

  • Optometrist
  • Yuba City, CA
  • NPI 1972697597
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1093912933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 N 18TH ST STE 104",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732600",
            "telephone_number": "360-424-4181",
            "fax_number": "360-424-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 N 18TH ST STE 104",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732600",
            "telephone_number": "360-424-4181",
            "fax_number": "360-424-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT VERNON VISION SOURCE PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TOD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-424-4181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024057",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410044967",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Moselle, MS, LMHC, NCC
• Mothership Birth Center PLLC
• Mothership Midwifery
• Briana Moulton
• Mount Vernon Chiropractic, Inc., P.S.
• Mount Vernon Womens Clinc Inc PS
• David Michael Mourning, M.D.
• Stephen Frederick Mowery, MD
• Mt. Vernon Operations, LLC (Life Care Center of Mount Vernon)
• Ellen Marie Muench, SLP

• Optometrist in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.