Organization Active NPI

Full Spectrum Eye Care, P.S.

Doing business as The Columbia River Eye Center Optical Shop

  • Eyewear Supplier
  • Richland, WA
National Provider Identifier
1144317983
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
FULL SPECTRUM EYE CARE, P.S.
Doing business as
The Columbia River Eye Center Optical Shop
Practice address
475 Bradley Blvd
Richland, WA 99352-4419
Phone
(509) 943-9055
Fax
(509) 943-1575
NPI assigned
Oct 5, 2006
Last updated
Jun 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Authorized official

Name
Dr. Devin Harrison, M.D.NPI 1447257266
Title
Owner
Phone
(509) 943-2240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X WA Primary

Addresses

Primary practice location

475 Bradley Blvd
Richland, WA 99352-4419

Mailing address

475 Bradley Blvd
Richland, WA 99352-4419
Phone (509) 943-9055

Other identifiers 1

IdentifierTypeStateIssuer
4383580001OtherWASTERLING INSURANCE

Other names 1

  • The Columbia River Eye Center Optical Shop Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930086093 WA DME Supplier - Physician - OptometristDME Supplier - Optician 3375432636 1 other NPI on this enrollment
Practice locations: Richland, WA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
The Columbia River Eye Center475 Bradley Blvd, Richland, WA 99352-4419(509) 943-2240 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Tax ID family
Full Spectrum Eye Care PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

475 Bradley Blvd
Richland, WA 99352
Phone (509) 895-4968

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243814400000",
    "number": "1144317983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BRADLEY BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524419",
            "telephone_number": "509-943-9055",
            "fax_number": "509-943-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BRADLEY BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524419",
            "telephone_number": "509-943-9055",
            "fax_number": "509-943-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SPECTRUM EYE CARE, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-06-01",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-943-2240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERLING INSURANCE",
            "identifier": "4383580001",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Columbia River Eye Center Optical Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.