NPIMap

Organization Active NPI

Robert W Creed OD PC

Doing business as Basin EyeCare Clinic

  • Optometrist
  • Klamath Falls, OR
National Provider Identifier
1598940082
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1756T Issued in OR
Legal business name
ROBERT W CREED OD PC
Doing business as
Basin EyeCare Clinic
Practice address
2424 Shasta Way
Klamath Falls, OR 97601-4354
Phone
(541) 882-2812
Fax
(541) 882-5075
NPI assigned
Jan 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Authorized official

Name
Dr. Robert W. Creed, O.D.NPI 1174616163
Title
President
Phone
(541) 882-2812

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1756T OR Primary

Addresses

Primary practice location

2424 Shasta Way
Klamath Falls, OR 97601-4354

Mailing address

2424 Shasta Way
Klamath Falls, OR 97601-4354
Phone (541) 882-2812

Other identifiers 1

IdentifierTypeStateIssuer
034780MedicaidOR

Other names 1

  • Basin EyeCare Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1598940082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 SHASTA WAY",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014354",
            "telephone_number": "541-882-2812",
            "fax_number": "541-882-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 SHASTA WAY",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014354",
            "telephone_number": "541-882-2812",
            "fax_number": "541-882-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W CREED OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "CREED",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-882-2812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1756T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034780",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Basin EyeCare Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.