Organization Active NPI

Whidbey Vision Care Inc PS

  • Optometrist
  • Oak Harbor, WA
National Provider Identifier
1497810071
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003987 Issued in WA
Legal business name
WHIDBEY VISION CARE INC PS
Practice address
380 SE Barrington Dr
Oak Harbor, WA 98277-3266
Phone
(360) 675-2235
Fax
(360) 679-2150
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Authorized official

Name
Holli Johnson
Title
Administrator
Phone
(360) 675-2235

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OD00003150 WA
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OD00003901 WA
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OD00003987 WA Primary

Addresses

Primary practice location

380 SE Barrington Dr
Oak Harbor, WA 98277-3266

Mailing address

380 SE Barrington Dr
Oak Harbor, WA 98277-3266
Phone (360) 675-2235

Other identifiers 3

IdentifierTypeStateIssuer
2006765MedicaidWA
2030591MedicaidWA
2031367MedicaidWA

National Provider Directory

National Provider Directory

Locations

1832 Scott Rd
Ste A3
Freeland, WA 98249
Phone (360) 331-8424

1690 Main St
#103
Freeland, WA 98249
Phone (360) 331-8424

380 SE Barrington Dr
Oak Harbor, WA 98277
Phone (360) 675-2235

Practitioners & affiliated clinicians

Practitioners 6

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": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1497810071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SE BARRINGTON DR",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773266",
            "telephone_number": "360-675-2235",
            "fax_number": "360-679-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 SE BARRINGTON DR",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773266",
            "telephone_number": "360-675-2235",
            "fax_number": "360-679-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHIDBEY VISION CARE INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "HOLLI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "360-675-2235"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003150",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003901",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2006765",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030591",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2031367",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.