NPIMap

Organization Active NPI

Great Vision Northwest

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1265807382
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60189678 Issued in WA
Legal business name
GREAT VISION NORTHWEST
Practice address
14230 NE 20TH St
Suite C
Bellevue, WA 98007-3741
Phone
(425) 748-1000
NPI assigned
Dec 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Authorized official

Name
Shane Oniel Durrant
Title
Optometrist
Phone
(614) 493-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 60189678 WA Primary

Addresses

Primary practice location

14230 NE 20TH St
Suite C
Bellevue, WA 98007-3741

Mailing address

14230 NE 20TH St
Suite C
Bellevue, WA 98007-3741
Phone (425) 748-1000

National Provider Directory

National Provider Directory

Locations

14230 NE 20th St
Ste C
Bellevue, WA 98007
Phone (425) 748-1000

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1265807382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14230 NE 20TH ST",
            "address_2": "SUITE C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073741",
            "telephone_number": "425-748-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14230 NE 20TH ST",
            "address_2": "SUITE C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073741",
            "telephone_number": "425-748-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT VISION NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "DURRANT",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "ONIEL",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "614-493-6440"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60189678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.