NPIMap

Organization Active NPI

Clearview Eye Clinic LTD

  • Ophthalmology Physician
  • Moscow, ID
National Provider Identifier
1407915325
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
M8044 Issued in ID
Legal business name
CLEARVIEW EYE CLINIC LTD
Practice address
2500 W a St
Suite 202
Moscow, ID 83843-6000
Phone
(208) 882-4662
Fax
(208) 883-6557
NPI assigned
Dec 6, 2006
Last updated
Mar 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Authorized official

Name
Dr. David Leach, M.DNPI 1043379944
Title
Owner President
Phone
(208) 882-4662

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP100095 ID
Ophthalmology Physician 207W00000X M8044 ID Primary

Addresses

Primary practice location

2500 W a St
Suite 202
Moscow, ID 83843-6000

Mailing address

2500 W a St
Suite 202
Moscow, ID 83843-6000
Phone (208) 882-4662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070920000367 ID Part B Supplier - Clinic/Group Practice 7416998232 Receives reassigned benefits from 6 practitioners
Practice locations: Lewiston, ID; Moscow, ID
O20091014000452 WA Part B Supplier - Clinic/Group Practice 7416998232 Receives reassigned benefits from 2 practitioners
Practice locations: Pullman, WA

National Provider Directory

National Provider Directory

Locations

1630 23rd Ave
Ste 201A
Lewiston, ID 83501
Phone (208) 746-5100

2500 W A St
Ste 202
Moscow, ID 83843
Phone (208) 746-5100

804 S Washington St
Ste B
Moscow, ID 83843
Phone (208) 882-4662

Practitioners & affiliated clinicians

Practitioners 10

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": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1407915325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W A ST",
            "address_2": "SUITE 202",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838436000",
            "telephone_number": "208-882-4662",
            "fax_number": "208-883-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W A ST",
            "address_2": "SUITE 202",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838436000",
            "telephone_number": "208-882-4662",
            "fax_number": "208-883-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARVIEW EYE CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "208-882-4662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP100095",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M8044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.