NPIMap

Organization Active NPI

Lifetime Eye Care Inc

  • Optometrist
  • Eugene, OR
National Provider Identifier
1316973985
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1551AT Issued in OR
Legal business name
LIFETIME EYE CARE INC
Practice address
4765 Village Plaza Loop
Ste 100
Eugene, OR 97401
Phone
(541) 342-3100
Fax
(541) 342-6153
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carol E Marusich, OD
Title
President
Phone
(541) 342-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1551AT OR Primary

Addresses

Primary practice location

4765 Village Plaza Loop
Ste 100
Eugene, OR 97401

Mailing address

4765 Village Plaza Loop
Ste 100
Eugene, OR 97401

Other identifiers 1

IdentifierTypeStateIssuer
229179MedicaidOR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316973985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 VILLAGE PLAZA LOOP",
            "address_2": "STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 VILLAGE PLAZA LOOP",
            "address_2": "STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-342-3100",
            "fax_number": "541-342-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME EYE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARUSICH",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-342-3100",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1551AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "229179",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.