NPIMap

Organization Active NPI

Vision Pendleton LLC

  • Optometrist
  • Pendleton, OR
National Provider Identifier
1487786455
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2399ATI Issued in OR
Legal business name
VISION PENDLETON LLC
Practice address
1815 SW Emigrant Ave
Pendleton, OR 97801-1843
Phone
(541) 276-3653
Fax
(541) 966-4322
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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

Authorized official

Name
Peter AndertonNPI 1932955978
Title
President
Phone
(541) 276-3653

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
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2399ATI OR Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2456ATI OR

Addresses

Primary practice location

1815 SW Emigrant Ave
Pendleton, OR 97801-1843

Mailing address

1815 SW Emigrant Ave
Pendleton, OR 97801-1843
Phone (541) 276-3653

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000939 OR Part B Supplier - Clinic/Group Practice 7315932068 Receives reassigned benefits from 4 practitioners
Practice locations: Pendleton, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783036800000",
    "number": "1487786455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 SW EMIGRANT AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978011843",
            "telephone_number": "541-276-3653",
            "fax_number": "541-966-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 SW EMIGRANT AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978011843",
            "telephone_number": "541-276-3653",
            "fax_number": "541-966-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION PENDLETON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A",
        "authorized_official_last_name": "ANDERTON",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-276-3653"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2399ATI",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2456ATI",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; 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.