NPIMap

Organization Active NPI

Lewis County Vision Source PC

Doing business as Dr. Kelly Padgett

  • Optometrist
  • Centralia, WA
National Provider Identifier
1356710933
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60236154 Issued in WA
Legal business name
LEWIS COUNTY VISION SOURCE PC
Doing business as
Dr. Kelly Padgett
Practice address
1805 Cooks Hill Rd
Centralia, WA 98531-9072
Phone
(360) 736-4447
Fax
(360) 807-0324
NPI assigned
Sep 24, 2015
Last updated
Dec 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Authorized official

Name
Kelly Michele Padgett, ODNPI 1487933610
Title
Owner
Phone
(360) 736-4447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60236154 WA Primary

Addresses

Primary practice location

1805 Cooks Hill Rd
Centralia, WA 98531-9072

Mailing address

1805 Cooks Hill Rd
Centralia, WA 98531-9072
Phone (360) 736-4447

Other names 1

  • Dr. Kelly Padgett Doing business as

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": "1443052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1356710933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319072",
            "telephone_number": "360-736-4447",
            "fax_number": "360-807-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319072",
            "telephone_number": "360-736-4447",
            "fax_number": "360-807-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS COUNTY VISION SOURCE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "PADGETT",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-736-4447",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60236154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Kelly Padgett",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.