Active NPI
Rosanne F Schneller, O.D.
- Optometrist
- Walla Walla, WA
National Provider Identifier
1578642500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1914TX
- Practice address
- 614 E Alder St Ste 1
Walla Walla, WA 99362-2073 - Phone
- (509) 527-3937
- Fax
- (509) 529-4750
- NPI assigned
- Nov 2, 2006
- Last updated
- Oct 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1914TX | WA | Primary |
| Optometrist | 152W00000X | 1947T | OR |
Addresses
Primary practice location
614 E Alder St Ste 1
Walla Walla, WA 99362-2073
Mailing address
614 E Alder St Ste 1
Walla Walla, WA 99362-2073
Phone (509) 527-3937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2017911 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Crystalpm | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1947T | OR | MD | Optometrist |
| 1914TX | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Source Walla Walla PLLC | Optometrist | Current | Accepting new patients |
Locations
614 E Alder St
Ste 1
Walla Walla, WA 99362
Phone (509) 527-3937
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Walla Walla, WA
- NPI 1245077080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572480000000",
"number": "1578642500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 E ALDER ST STE 1",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993622073",
"telephone_number": "509-527-3937",
"fax_number": "509-529-4750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 E ALDER ST STE 1",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993622073",
"telephone_number": "509-527-3937",
"fax_number": "509-529-4750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHNELLER",
"first_name": "ROSANNE",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2019-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "1914TX",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "1947T",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2017911",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Crystalpm",
"affiliation": "N",
"endpointDescription": "Crystalpm",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "614 E Alder St Ste 1",
"city": "Walla Walla",
"state": "WA",
"country_code": "US",
"postal_code": "993622073",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.