Active NPI
Spectrum Eye Care Inc PS
- Optometrist
- Chelan, WA
National Provider Identifier
1285675140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 003674
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2025179 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040329001136 | WA | Part B Supplier - Clinic/Group Practice | 0143112573 | Practice locations: Chelan, WA; Wenatchee, WA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Optometrist
- Stillwater, OK
- NPI 1891731816
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.