Organization Active NPI

Frontline Vision

  • Optometrist
  • Spokane Valley, WA
National Provider Identifier
1417712241
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FRONTLINE VISION
Practice address
604 S Sullivan Rd Ste D
Spokane Valley, WA 99037-5129
Phone
(509) 425-0335
NPI assigned
Feb 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Kalina Harrell, ODNPI 1922739200
Title
Owner
Phone
(509) 425-0335

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 Primary

Addresses

Primary practice location

604 S Sullivan Rd Ste D
Spokane Valley, WA 99037-5129

Mailing address

16314 E Whirlaway LN
Veradale, WA 99037-8879
Phone (480) 321-6805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241209000443 WA Part B Supplier - Clinic/Group Practice 6305372848 Receives reassigned benefits from 1 practitioner
Practice locations: Spokane Valley, WA

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.

NPI Registry JSON

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1417712241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16314 E WHIRLAWAY LN",
            "city": "VERADALE",
            "state": "WA",
            "postal_code": "990378879",
            "telephone_number": "480-321-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S SULLIVAN RD STE D",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990375129",
            "telephone_number": "509-425-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTLINE VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "KALINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-425-0335",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.