Organization Active NPI

Today's Vision Clinic, LLC

  • Optometrist
  • Newberg, OR
National Provider Identifier
1285936773
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2591ATI Issued in OR
Legal business name
TODAY'S VISION CLINIC, LLC
Practice address
901 Brutscher St Ste E
Newberg, OR 97132-6096
Phone
(503) 554-5555
Fax
(503) 538-1896
NPI assigned
Dec 3, 2010
Last updated
Dec 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
Dr. Jose Marin Jr., OD
Title
Owner
Phone
(503) 554-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2591ATI OR Primary

Addresses

Primary practice location

901 Brutscher St Ste E
Newberg, OR 97132-6096

Mailing address

901 Brutscher St Ste E
Newberg, OR 97132-6096
Phone (503) 554-5555

Other identifiers 1

IdentifierTypeStateIssuer
150665MedicaidOR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1285936773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BRUTSCHER ST STE E",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971326096",
            "telephone_number": "503-554-5555",
            "fax_number": "503-538-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BRUTSCHER ST STE E",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971326096",
            "telephone_number": "503-554-5555",
            "fax_number": "503-538-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODAY'S VISION CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "MARIN",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-554-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2591ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150665",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.