NPIMap

Organization Active NPI

Whatcom Vision Clinics LLC

  • Optometrist
  • Bellingham, WA
National Provider Identifier
1407804552
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003766 Issued in WA
Legal business name
WHATCOM VISION CLINICS LLC
Practice address
2222 James St
Ste a
Bellingham, WA 98225-4152
Phone
(360) 676-4030
Fax
(360) 676-8719
NPI assigned
May 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Dr. Brad D Bearden, ODNPI 1770798407
Title
Owner
Phone
(360) 676-4030

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD00003766 WA Primary

Addresses

Primary practice location

2222 James St
Ste a
Bellingham, WA 98225-4152

Mailing address

2222 James St
Ste a
Bellingham, WA 98225-4152
Phone (360) 676-4030

Other identifiers 1

IdentifierTypeStateIssuer
2019883MedicaidWA

Other names 1

  • Optometric Physicians NW Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000841 WA Part B Supplier - Clinic/Group Practice 7618866732 Receives reassigned benefits from 5 practitioners
Practice locations: Bellingham, WA

National Provider Directory

National Provider Directory

Locations

2222 James St
Ste A
Bellingham, WA 98225
Phone (360) 676-4030

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1407804552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 JAMES ST",
            "address_2": "STE A",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254152",
            "telephone_number": "360-676-4030",
            "fax_number": "360-676-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 JAMES ST",
            "address_2": "STE A",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254152",
            "telephone_number": "360-676-4030",
            "fax_number": "360-676-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHATCOM VISION CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "BEARDEN",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-676-4030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019883",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optometric Physicians NW",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Optometric Physicians NW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.