NPIMap

Organization Active NPI

South Hill Vision Clinic

  • Optometrist
  • Puyallup, WA
National Provider Identifier
1467597633
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SOUTH HILL VISION CLINIC
Practice address
12511 Meridian E Ste 101
Puyallup, WA 98373-3425
Phone
(253) 848-8988
Fax
(253) 841-2374
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
David B Souza, ODNPI 1811904964
Title
Partner
Phone
(253) 848-8988

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 WA Primary

Addresses

Primary practice location

12511 Meridian E Ste 101
Puyallup, WA 98373-3425

Mailing address

12511 Meridian E Ste 101
Puyallup, WA 98373-3425
Phone (253) 848-8988

National Provider Directory

National Provider Directory

Locations

12511 Meridian E
Puyallup, WA 98373
Phone (206) 848-1584

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": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1467597633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12511 MERIDIAN E STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733425",
            "telephone_number": "253-848-8988",
            "fax_number": "253-841-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12511 MERIDIAN E STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733425",
            "telephone_number": "253-848-8988",
            "fax_number": "253-841-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HILL VISION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "SOUZA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "253-848-8988",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.