NPIMap

Organization Active NPI

Associated Westside Optometric Clinic P.a.

  • Optometrist
  • Idaho Falls, ID
National Provider Identifier
1154493708
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-546 Issued in ID
Legal business name
ASSOCIATED WESTSIDE OPTOMETRIC CLINIC P.A.
Practice address
1991 W Broadway St Ste 2
Idaho Falls, ID 83402-3041
Phone
(208) 529-4333
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Douglas James HilbornNPI 1831182682
Title
Owner
Phone
(208) 529-4333

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
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X ODP-546 ID Primary

Addresses

Primary practice location

1991 W Broadway St Ste 2
Idaho Falls, ID 83402-3041

Mailing address

1991 W Broadway St Ste 2
Idaho Falls, ID 83402-3041

National Provider Directory

National Provider Directory

Locations

1991 W Broadway St
#2
Idaho Falls, ID 83402
Phone (208) 529-4333

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154493708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 W BROADWAY ST STE 2",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 W BROADWAY ST STE 2",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023041",
            "telephone_number": "208-529-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED WESTSIDE OPTOMETRIC CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HILBORN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-529-4333",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.