Organization Active NPI

Spectrum Eye Care Inc PS

  • Optometrist
  • Chelan, WA
National Provider Identifier
1285675140
Registry record updated Nov 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
003674 Issued in WA
Legal business name
SPECTRUM EYE CARE INC PS
Practice address
126 E Johnson
Chelan, WA 98816-3100
Phone
(509) 682-2708
Fax
(509) 682-2713
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2023

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

Authorized official

Name
Mrs. Lee Anne H Scott
Title
Administrator
Phone
(509) 682-2708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 003674 WA Primary

Addresses

Primary practice location

126 E Johnson
Chelan, WA 98816-3100

Mailing address

PO Box 3142
Wenatchee, WA 98807-3142
Phone (509) 682-2708

Other practice location 1

108 N Apple Blossom Dr
Chelan, WA 98816-8679
Phone (509) 682-2708

Other practice location 2

2000 N Wenatchee Ave
Wenatchee, WA 98801-1056
Phone (509) 682-2708

Other identifiers 1

IdentifierTypeStateIssuer
2025179MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040329001136 WA Part B Supplier - Clinic/Group Practice 0143112573 Practice locations: Chelan, WA; Wenatchee, WA

National Provider Directory

National Provider Directory

Locations

126 E Johnson Ave
Chelan, WA 98816
Phone (509) 682-2708

1005 N Stratford Rd
Moses Lake, WA 98837
Phone (509) 765-1024

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": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700352000000",
    "number": "1285675140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3142",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988073142",
            "telephone_number": "509-682-2708",
            "fax_number": "509-682-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E JOHNSON",
            "city": "CHELAN",
            "state": "WA",
            "postal_code": "988163100",
            "telephone_number": "509-682-2708",
            "fax_number": "509-682-2713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 N Apple Blossom Dr",
            "address_purpose": "LOCATION",
            "city": "Chelan",
            "state": "WA",
            "postal_code": "988168679",
            "country_code": "US",
            "telephone_number": "509-682-2708",
            "fax_number": "509-682-2713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 N Wenatchee Ave",
            "address_purpose": "LOCATION",
            "city": "Wenatchee",
            "state": "WA",
            "postal_code": "988011056",
            "country_code": "US",
            "telephone_number": "509-682-2708",
            "fax_number": "509-682-2713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECTRUM EYE CARE INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "LEE ANNE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "509-682-2708",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "003674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025179",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelan, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.