Robert D Rolen III OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1795ATI Issued in OR

Legal business name

ROBERT D ROLEN III OD LLC

Practice address

115 W Hermiston Ave Ste 130
Hermiston, OR 97838-1762

Phone

(541) 567-1837

Fax

(541) 289-2022

NPI assigned

Aug 23, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Robert Rolen, O.D.

Title

Optometrist

Phone

(541) 567-1837

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1295015113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W HERMISTON AVE STE 130",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978381762",
            "telephone_number": "541-567-1837",
            "fax_number": "541-289-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W HERMISTON AVE STE 130",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978381762",
            "telephone_number": "541-567-1837",
            "fax_number": "541-289-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT D ROLEN III OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "ROLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "541-567-1837",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1795ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150839",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS",
            "identifier": "48267",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard a. Flaiz
• Edward A Ricketts, MD
• Kelsie Marie Riley
• Rhonda Jean Riley, MA
• Randel Ripka
• Robert J. Berecz, M.D., F.a.C.S., P.C.
• Shirley Ann Robins, PC
• Jamie Elizabeth Robinson, MD
• Debora Garcia Rodriguez, QMHA
• Robert D Rolen III, O.D.

• Optometrist in Hermiston, OR
• Providers in Hermiston, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.