NPIMap

Organization Active NPI

Dr. Dallas Carr and Associates

  • Medical Specialty Clinic/Center
  • Olympia, WA
National Provider Identifier
1487700407
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
OD00001152 Issued in WA
Legal business name
DR. DALLAS CARR AND ASSOCIATES
Practice address
625 Black Lake Blvd SW
Suite 110
Olympia, WA 98502-5066
Phone
(360) 943-1516
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Dr. Dallas Robert Carr, O.D.
Title
Owner
Phone
(360) 943-1516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X OD00001152 WA Primary

Addresses

Primary practice location

625 Black Lake Blvd SW
Suite 110
Olympia, WA 98502-5066

Mailing address

625 Black Lake Blvd SW
Suite 110
Olympia, WA 98502-5066
Phone (360) 943-1516

Other identifiers 1

IdentifierTypeStateIssuer
2027159MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1487700407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BLACK LAKE BLVD SW",
            "address_2": "SUITE 110",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025066",
            "telephone_number": "360-943-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BLACK LAKE BLVD SW",
            "address_2": "SUITE 110",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025066",
            "telephone_number": "360-943-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DALLAS CARR AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "DALLAS",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-943-1516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "OD00001152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2027159",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.