Forest Grove Family Eye Care, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3381ATI Issued in OR

Legal business name

FOREST GROVE FAMILY EYE CARE, P.C.

Practice address

2804 19TH Ave
Forest Grove, OR 97116-2625

Phone

(503) 357-2020

Fax

(503) 357-6995

NPI assigned

Aug 3, 2010

Organization subpart

No

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

Authorized official

Name

Eli Richardson, O.D.NPI 1578877056

Title

President

Phone

(503) 357-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 1

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

• Eli Richardson, O.D.

  • Optometrist
  • Forest Grove, OR
  • NPI 1578877056
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1124332069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971160847",
            "telephone_number": "503-357-2020",
            "fax_number": "503-357-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 19TH AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162625",
            "telephone_number": "503-357-2020",
            "fax_number": "503-357-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST GROVE FAMILY EYE CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "ELI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-357-2020",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3381ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janeen VI Flake, RPH
• Kate Flanagan, LPC
• Cheryl Lee Fletcher
• Sarah Elizabeth Foidel, OTR/L
• Forest Grove Chiropractic LLC
• Forest Grove Kids' Dentist, LLC
• Forest Grove Medical PC
• Forest Grove Pediatrics PC
• Forest Grove SNF Healthcare LLC
• Charlotte Forgie, O.D.

• Optometrist in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.