Vester Eye Clinic LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0640 Issued in ID

Legal business name

VESTER EYE CLINIC LLC

Practice address

425 Pine St
Wallace, ID 83873-2256

Phone

(208) 752-2020

Fax

(208) 556-7971

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dick L Vester, O.D.

Title

Optometrist/Owner

Phone

(208) 752-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vester Eye Clinic Other name

Locations

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244764800000",
    "number": "1497769186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINE ST",
            "city": "WALLACE",
            "state": "ID",
            "postal_code": "838732256",
            "telephone_number": "208-752-2020",
            "fax_number": "208-556-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE ST",
            "city": "WALLACE",
            "state": "ID",
            "postal_code": "838732256",
            "telephone_number": "208-752-2020",
            "fax_number": "208-556-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VESTER EYE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2009-06-12",
        "status": "A",
        "authorized_official_last_name": "VESTER",
        "authorized_official_first_name": "DICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "208-752-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "0640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000783200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vester Eye Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Wallace, ID
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; 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.