Paulson Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

License

1359AT Issued in OR

Legal business name

PAULSON EYECARE

Practice address

586 5TH St Ste 300
Brookings, OR 97415-9720

Phone

(541) 469-7775

NPI assigned

Jun 14, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wayne R Paulson, O.D.NPI 1699887158

Title

Optometrist

Phone

(541) 469-7775

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Wayne Robert Paulson, O.D.

  • Optometrist
  • Brookings, OR
  • NPI 1699887158
  NPD (past) Authorized official

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225232986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 5TH ST STE 300",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159720",
            "telephone_number": "541-469-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 5TH ST STE 300",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159720",
            "telephone_number": "541-469-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULSON EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAULSON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "541-469-7775",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1359AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236091",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1699887158",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Armida Padilla
• Palak J Patel
• Jitendra C Patel, MD
• Palak Jitendra Patel, MD
• Brittney Dawn Patton
• Wayne Robert Paulson, O.D.
• William Payne
• Kristine M Perrotti Floyd, OCCUPATIONAL THERAPI
• Jan Perrotti
• Julie Catherine Peterson

• Optometrist in Brookings, OR
• Providers in Brookings, OR by specialty
• Optometrist in Oregon

• 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.