NPIMap

Organization Active NPI

Fenno Eye Clinics Inc., P.S.

  • Optometrist
  • Colville, WA
National Provider Identifier
1154463669
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1708TX Issued in WA
Legal business name
FENNO EYE CLINICS INC., P.S.
Practice address
102 S Oak St
Colville, WA 99114-2846
Phone
(509) 684-5278
NPI assigned
Feb 12, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Michael Fenno
Title
President
Phone
(509) 684-5278

Practitioners 22

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

View all 22

National Provider Directory

National Provider Directory

Locations

102 S Oak St
Colville, WA 99114
Phone (509) 684-5278

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1708TX WA Primary

Addresses

NPPES NPI Registry

Primary practice location

102 S Oak St
Colville, WA 99114-2846

Mailing address

102 S Oak St
Colville, WA 99114-2846

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
2022960MedicaidWA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 3, 2010.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1154463669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S OAK ST",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S OAK ST",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142846",
            "telephone_number": "509-684-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENNO EYE CLINICS INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "FENNO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-684-5278"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1708TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022960",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.