NPIMap

Organization Active NPI

All Family Vision LLC

  • Optometrist
  • Corvallis, OR
National Provider Identifier
1255600763
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2515T Issued in OR
Legal business name
ALL FAMILY VISION LLC
Practice address
1597 SW 53Rd St
Corvallis, OR 97333-2630
Phone
(541) 757-8844
NPI assigned
Dec 29, 2011
Last updated
Aug 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Authorized official

Name
Dr. Justin Heintz, ODNPI 1548499882
Title
Owner
Phone
(541) 757-8844

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
Eyewear Supplier 332H00000X NU
Optometrist 152W00000X 3307ATI OR
Optometrist 152W00000X 2515T OR Primary

Addresses

Primary practice location

1597 SW 53Rd St
Corvallis, OR 97333-2630

Mailing address

1597 SW 53Rd St
Corvallis, OR 97333-2630
Phone (541) 757-8844

Other identifiers 2

IdentifierTypeStateIssuer
R163394OtherORMEDICARE PTAN
R163171OtherORMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120319000779 OR Part B Supplier - Clinic/Group Practice 5890955413 Receives reassigned benefits from 7 practitioners
Practice locations: Salem, OR; Corvallis, OR

National Provider Directory

National Provider Directory

Locations

1597 SW 53rd St
Corvallis, OR 97333
Phone (541) 757-8844

990 Broadway St NE
Ste 100
Salem, OR 97301
Phone (503) 364-0767

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565568000000",
    "number": "1255600763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1597 SW 53RD ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973332630",
            "telephone_number": "541-757-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1597 SW 53RD ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973332630",
            "telephone_number": "541-757-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL FAMILY VISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2019-08-12",
        "status": "A",
        "authorized_official_last_name": "HEINTZ",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-757-8844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3307ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2515T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R163394",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R163171",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.