Grange Ophthalmology, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

GRANGE OPHTHALMOLOGY, PLLC

Practice address

450 W State St Ste 250
Eagle, ID 83616-6974

Phone

(208) 506-7966

Fax

(208) 277-3857

NPI assigned

Apr 8, 2022

Organization subpart

No

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

Authorized official

Name

Laura Rae Nolder

Title

Office Manager

Phone

(208) 989-7151

Specialties & licenses 1

Addresses

Other names 1

• Grange Eye Care Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: lgrange@grangeeyecare.intellechartdirect.net

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Landon Kelly Grange, M.D.

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1043620255
  Medicare reassignment NPD
• Justin Mark Rowe, O.D.

  • Optometrist
  • McCall, ID
  • NPI 1598954638
  NPD (past)

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1285376558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W STATE ST STE 250",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166974",
            "telephone_number": "208-506-7966",
            "fax_number": "208-277-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W STATE ST STE 250",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166974",
            "telephone_number": "208-506-7966",
            "fax_number": "208-277-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANGE OPHTHALMOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-08",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "NOLDER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-989-7151"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.nextech.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8039 N Sundial Way",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837142508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.nextech.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "450 W State St Ste 250",
            "city": "Eagle",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836166974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Grange Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Golden Hour Acupuncture & Wellness
• Golden Hour Acupuncture & Wellness
• Hannah Wenle Gottenberg, LPC
• Nicholas Grable, DC
• Sarah Jo Graham, MPT
• Grange Surgery Center PLLC
• Alan James Gray, MD
• Katie Gray, M.S.
• Sariah Gray
• Alexandria Cavaretta Green, APRN-CNP

• Ophthalmology Physician in Eagle, ID
• Providers in Eagle, ID by specialty
• Ophthalmology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.