River City Eyecare, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

RIVER CITY EYECARE, LLC

Practice address

9201 SE 91St Ave
Suite 130
Clackamas, OR 97086-3760

Phone

(503) 775-2424

Fax

(503) 775-6181

NPI assigned

Oct 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Carrie L Breeden, O.D.NPI 1528216793

Title

Owner/Member

Phone

(503) 775-2424

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carrie Lynn Breeden, O.D.

  • Optometrist
  • Clackamas, OR
  • NPI 1528216793
  Medicare reassignment Care Compare group Authorized official
• Bret A. Provost, O.D.

  • Optometrist
  • Clackamas, OR
  • NPI 1528093556
  Medicare reassignment Care Compare group NPD
• Gwen Thilavanh

  • Optometrist
  • Happy Valley, OR
  • NPI 1902269525
  Medicare reassignment Care Compare group NPD
• Johnny Duong, O.D.

  • Optometrist
  • Portland, OR
  • NPI 1811370968
  Medicare reassignment NPD

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1578899472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 SE 91ST AVE",
            "address_2": "SUITE 130",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970863760",
            "telephone_number": "503-775-2424",
            "fax_number": "503-775-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 SE 91ST AVE",
            "address_2": "SUITE 130",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970863760",
            "telephone_number": "503-775-2424",
            "fax_number": "503-775-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "BREEDEN",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "503-775-2424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Nicole Riley
• Keith B. Riley, M.D.
• Deborah Lynn Rink, LCSW
• Kelly A Riordan, CNM
• Pamela S Ritchie, M.S.
• Alexander Adonis Lee Robbinson, NREMT, PSS
• Robert D. Grew DMD, Inc.
• Jenessa Denise Roberti, DACM
• Karen Lynn Roberti, LMT
• Robert Lee Roberts, D.O.

• Eyewear Supplier in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Eyewear Supplier in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.