Individual provider Active NPI

Fraser Campbell Horn, O.D.

  • Sports Vision Optometrist
  • Forest Grove, OR
National Provider Identifier
1467436766
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Vision OptometristTaxonomy code 152WS0006X
License
3111AT Issued in OR
Practice address
2043 College Way
Forest Grove, OR 97116-1756
Phone
(503) 357-2020
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Vision Optometrist 152WS0006X 3111AT OR Primary

Addresses

Primary practice location

2043 College Way
Forest Grove, OR 97116-1756

Mailing address

2043 College Way
Forest Grove, OR 97116-1756
Phone (503) 357-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025000045 OR Practitioner - Optometry 3476570904 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific University Current Accepting new patients
Pacific University CurrentSince Jul 13, 2022 Accepting new patients
Bruce R Wojciechowski Past Accepting new patients
Northwest Eye Care LLC PastSince Jul 1, 2015 Accepting new patients

Locations

2043 College Way
Forest Grove, OR 97116
Phone (503) 352-2020

222 SE 8th Ave
Ste 114
Hillsboro, OR 97123
Phone (503) 352-7300

Interoperability endpoints

  • Direct secure messaging: fhorn315791@direct.ochin.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1467436766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161756",
            "telephone_number": "503-357-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161756",
            "telephone_number": "503-357-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "FRASER",
        "middle_name": "CAMPBELL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "OR",
            "license": "3111AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Grove, OR

Sources for this page

Verify at the official NPI Registry.