Organization Active NPI

Vivid Eye Care Inc

  • Optometrist
  • Hillsboro, OR
National Provider Identifier
1295971182
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2932 ATI Issued in OR
Legal business name
VIVID EYE CARE INC
Practice address
6506 NE Campus Way
Hillsboro, OR 97124-7454
Phone
(503) 640-2020
Fax
(503) 640-1162
NPI assigned
Dec 23, 2008
Last updated
Sep 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Authorized official

Name
Dr. Linda Tran Knutson, O.D.NPI 1962534081
Title
Member
Phone
(503) 640-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2932 ATI OR Primary

Addresses

Primary practice location

6506 NE Campus Way
Hillsboro, OR 97124-7454

Mailing address

6506 NE Campus Way
Hillsboro, OR 97124-7454
Phone (503) 640-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140130000224 OR Part B Supplier - Clinic/Group Practice 7012146780 Receives reassigned benefits from 4 practitioners
Practice locations: Hillsboro, OR

National Provider Directory

National Provider Directory

Locations

6506 NE Campus Way
Hillsboro, OR 97124
Phone (503) 640-2020

7393 NE Butler St
Hillsboro, OR 97124
Phone (503) 640-2020

Practitioners & affiliated clinicians

Practitioners 4

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": "1229990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410825600000",
    "number": "1295971182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6506 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247454",
            "telephone_number": "503-640-2020",
            "fax_number": "503-640-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6506 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247454",
            "telephone_number": "503-640-2020",
            "fax_number": "503-640-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID EYE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-23",
        "last_updated": "2014-09-16",
        "status": "A",
        "authorized_official_last_name": "KNUTSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "TRAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-640-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2932 ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.