Columbia Basin Eye Clinic PS

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD000029599 Issued in WA

Legal business name

COLUMBIA BASIN EYE CLINIC PS

Practice address

1022 W Ivy Ave
Moses Lake, WA 98837-4107

Phone

(509) 765-7845

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Laura L Bator

Title

Office Manager

Phone

(509) 765-7845

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 3

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

• Janet L. Huber, O.D.

  • Optometrist
  • Moses Lake, WA
  • NPI 1598768731
  Medicare reassignment Care Compare group NPD
• Brian P. Roth, M.D.

  • Ophthalmology Physician
  • Moses Lake, WA
  • NPI 1649273889
  Medicare reassignment Care Compare group NPD
• Timothy Charles Thomas, OD

  • Optometrist
  • Moses Lake, WA
  • NPI 1548250905
  Medicare reassignment NPD

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1124159736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 W IVY AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374107",
            "telephone_number": "509-765-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 W IVY AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374107",
            "telephone_number": "509-765-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA BASIN EYE CLINIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "BATOR",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-765-7845"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00002028",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD000029599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G319211400",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Cole, CNM
• Troy Forrest Cole, PH (PHARMACIST)
• Sean Barry Collette, D.D.S.
• Sheila Fay Collins, DDS
• Columbia Basin Anesthesia PLLC
• Columbia Basin Natural Family Medicine PLLC
• Comprehensive Family Care PLLC
• Aislynn Olivia Conger
• Mary Lucretia Conklin
• Conrado Deleon MD

• Ophthalmology Physician in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Ophthalmology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.