Montesano Vision Center PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD 3739 Issued in WA

Legal business name

MONTESANO VISION CENTER PLLC

Practice address

118 S Main St
Montesano, WA 98563-3709

Phone

(360) 249-3485

NPI assigned

Jun 27, 2011

Organization subpart

No

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

Authorized official

Name

Geoffrey F WillsNPI 1932217361

Title

Member

Phone

(360) 249-3485

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Geoffrey Forrest Wills, O.D.

  • Optometrist
  • Montesano, WA
  • NPI 1932217361
  NPD Authorized official
• Robert Vincent Wickes, O.D.

  • Optometrist
  • Montesano, WA
  • NPI 1215026489
  NPD (past)

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314230400000",
    "number": "1104112358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S MAIN ST",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985633709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S MAIN ST",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985633709",
            "telephone_number": "360-249-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTESANO VISION CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-08-25",
        "status": "A",
        "authorized_official_last_name": "WILLS",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "360-249-3485"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 3739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith J Miller, ARNP
• Montesano Internal Medicine, PS
• Montesano Physical Therapy Inc.
• Montesano School District
• Montesano Spa Works and Massage, LLC
• Kendra Alexis Morscheck, DPT
• Natures Way Chiropractic, Inc
• Carmen Noguer, LMT
• Taylor Ashley Osborne, NP
• Cherie Page, LMP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.