Organization Active NPI

Lisa L Robinson OD PC

Doing business as Coeur d Alene Eye Care

  • Optometrist
  • Coeur d'Alene, ID
National Provider Identifier
1184854408
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-906 Issued in ID
Legal business name
LISA L ROBINSON OD PC
Doing business as
Coeur d Alene Eye Care
Practice address
409 W Neider Ave Ste C
Coeur D Alene, ID 83815-9423
Phone
(208) 765-5665
Fax
(208) 765-1716
NPI assigned
Jul 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Dr. Lisa L Robinson, OPTOMETRIST
Title
Owner
Phone
(208) 765-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X ODP-906 ID Primary

Addresses

Primary practice location

409 W Neider Ave Ste C
Coeur D Alene, ID 83815-9423

Mailing address

409 W Neider Ave Ste C
Coeur D Alene, ID 83815-9423
Phone (208) 765-5665

Other identifiers 1

IdentifierTypeStateIssuer
1184854408MedicaidID

Other names 1

  • Coeur d Alene Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

409 W Neider Ave
Ste C
Coeur D Alene, ID 83815
Phone (208) 765-5665

2112 N Government Way
Coeur D Alene, ID 83814
Phone (208) 765-5665

Practitioners & affiliated clinicians

Practitioners 1

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": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1184854408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W NEIDER AVE STE C",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159423",
            "telephone_number": "208-765-5665",
            "fax_number": "208-765-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W NEIDER AVE STE C",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159423",
            "telephone_number": "208-765-5665",
            "fax_number": "208-765-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA L ROBINSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-765-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OPTOMETRIST"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184854408",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coeur d Alene Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coeur d'Alene, ID

Sources for this page

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