Harry Walter Wiessner, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001578 Issued in WA

Practice address

614 E Alder St
Suite #1
Walla Walla, WA 99362-2073

Phone

(509) 527-3937

Fax

(509) 529-4750

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Source Walla Walla PLLCGroup PAC ID 0143752576, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vision Source Walla Walla PLLC

  • Optometrist
  • Walla Walla, WA
  • NPI 1245077080
  Medicare reassignment Care Compare group
• Paradocs, Inc. PS

  dba Blue Mountain Vision Clinic

  • Optometrist
  • Walla Walla, WA
  • NPI 1891999173
  NPD (past)

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1386637668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E ALDER ST",
            "address_2": "SUITE #1",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622073",
            "telephone_number": "509-527-3937",
            "fax_number": "509-529-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 E ALDER ST",
            "address_2": "SUITE #1",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622073",
            "telephone_number": "509-527-3937",
            "fax_number": "509-529-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESSNER",
        "first_name": "HARRY",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2300036",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G8900643",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arlene Lavonne Whitney, LCSW, MPH/MSW
• Richard Wick, M.D.
• Joshua Wicks, PA
• Teresa Wiedemann, LICSW
• Daniel James Wiessner, O.D.
• Michael J Wilcox, M.D.
• Kyle B Wiley, PT, DPT, ATC
• Katie Wilkinson, LMHCA
• Kirk Ellsworth Willard, MD
• William BL Murdoch DDS

• Optometrist in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.