Individual provider Active NPI

Rosanne F Schneller, O.D.

  • Optometrist
  • Walla Walla, WA
National Provider Identifier
1578642500
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1914TX Issued in WA
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, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2017911MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1947TORMDOptometrist
1914TXWAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Source Walla Walla PLLC Optometrist CurrentSince Jul 21, 2024 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.

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

Verify at the official NPI Registry.