NPIMap

Organization Active NPI

Modern Eyez Inc

  • Optometrist
  • West Linn, OR
National Provider Identifier
1508149063
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3272ATI Issued in OR
Legal business name
MODERN EYEZ INC
Practice address
18750 Willamette Dr Ste C
West Linn, OR 97068-1700
Phone
(503) 697-8879
NPI assigned
Sep 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Authorized official

Name
Dr. Ann Woods, OD
Title
Owner
Phone
(503) 312-6464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3272ATI OR Primary

Addresses

Primary practice location

18750 Willamette Dr Ste C
West Linn, OR 97068-1700

Mailing address

18750 Willamette Dr Ste C
West Linn, OR 97068-1700
Phone (503) 697-8879

National Provider Directory

National Provider Directory

Locations

18750 Willamette Dr
Ste C
West Linn, OR 97068
Phone (503) 697-8879

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": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1508149063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18750 WILLAMETTE DR STE C",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970681700",
            "telephone_number": "503-697-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18750 WILLAMETTE DR STE C",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970681700",
            "telephone_number": "503-697-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN EYEZ INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-312-6464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3272ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.