Individual provider Active NPI

Steven F Tronnes, OD

  • Optometrist
  • Roseburg, OR
National Provider Identifier
1528065356
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1409AT Issued in OR
Practice address
2435 NW Kline St
Roseburg, OR 97470-1690
Phone
(541) 672-2020
Fax
(541) 673-8084
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1409AT OR Primary

Addresses

Primary practice location

2435 NW Kline St
Roseburg, OR 97470-1690

Mailing address

2435 NW Kline St
Roseburg, OR 97470-1690
Phone (541) 672-2020

Other identifiers 1

IdentifierTypeStateIssuer
009191MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1409ATORMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1528065356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 NW KLINE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701690",
            "telephone_number": "541-672-2020",
            "fax_number": "541-673-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 NW KLINE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701690",
            "telephone_number": "541-672-2020",
            "fax_number": "541-673-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRONNES",
        "first_name": "STEVEN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1409AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009191",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.