Active NPI
Richard Barton Payne, O.D
- Optometrist
- Vancouver, WA
National Provider Identifier
1124100607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 00000943
- Practice address
- 314 E McLoughlin Blvd
Vancouver, WA 98663-3387 - Phone
- (360) 694-8303
- Fax
- (360) 694-9032
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 00000943 | WA | Primary |
Addresses
Primary practice location
314 E McLoughlin Blvd
Vancouver, WA 98663-3387
Mailing address
9508 SE 13TH St
Vancouver, WA 98664-3633
Phone (360) 256-6184
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024356001 | Other | WA | REGENCE |
| 212767 | Other | WA | EYE MED |
| 0199300 | Other | WA | DEPT. OF LABOR AND INDUST |
| 410008557 | Other | WA | RR MEDICARE |
| 2004273 | Medicaid | WA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00000943 | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vancouver Contact Lens & Vision Clinic Inc | Optometrist | 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 and National Provider Directory roles.
-
- Optometrist
- Camas, WA
- NPI 1124163167
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1124100607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9508 SE 13TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986643633",
"telephone_number": "360-256-6184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 E MCLOUGHLIN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986633387",
"telephone_number": "360-694-8303",
"fax_number": "360-694-9032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "RICHARD",
"middle_name": "BARTON",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "00000943",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "024356001",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYE MED",
"identifier": "212767",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT. OF LABOR AND INDUST",
"identifier": "0199300",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "410008557",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2004273",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.