Organization Active NPI

Cole Optometric Corporation

  • Optometrist
  • Eureka, CA
National Provider Identifier
1174046395
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
COLE OPTOMETRIC CORPORATION
Doing business as
Cole Family Eye Care Optometry
Practice address
2773 Harris St Ste H
Eureka, CA 95503-4866
Phone
(707) 445-4126
NPI assigned
Jul 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Authorized official

Name
Dr. Aaron Cole, ODNPI 1841525920
Title
President/Optometrist
Phone
(707) 445-4126

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Corneal and Contact Management OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WC0802X
Pediatric OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WP0200X

Addresses

Primary practice location

2773 Harris St Ste H
Eureka, CA 95503-4866

Mailing address

2773 Harris St Ste H
Eureka, CA 95503-4866

Other names 1

  • Cole Family Eye Care Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171116002650 CA Part B Supplier - Clinic/Group Practice 6204192602 Receives reassigned benefits from 1 practitioner
Practice locations: Eureka, CA

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2258597Cole Family Eye Care Optometry2773 Harris Street, Suite H, Eureka, CA 95503Certificate of waiverApr 24, 2028

National Provider Directory

National Provider Directory

Locations

2773 Harris St
Ste H
Eureka, CA 95503
Phone (707) 445-4126

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": "1500422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512000000000",
    "number": "1174046395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2773 HARRIS ST STE H",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2773 HARRIS ST STE H",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034866",
            "telephone_number": "707-445-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLE OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-19",
        "last_updated": "2017-11-30",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "707-445-4126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cole Family Eye Care Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cole Family Eye Care Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.