Ephrata Eye Care, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1908 Issued in WA

Legal business name

EPHRATA EYE CARE, PLLC

Practice address

1070 Basin St SW Ste F
Ephrata, WA 98823-1005

Phone

(509) 754-2020

Fax

(509) 754-9243

NPI assigned

Sep 2, 2010

Organization subpart

No

Name

Pamela Clayton

Title

Manager

Phone

(509) 754-2020

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

• George T Sisson, OD

  • Optometrist
  • Ephrata, WA
  • NPI 1811983299
  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in WA

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 1, 2012.

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1629385232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 BASIN ST SW STE F",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988231005",
            "telephone_number": "509-754-2020",
            "fax_number": "509-754-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 BASIN ST SW STE F",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988231005",
            "telephone_number": "509-754-2020",
            "fax_number": "509-754-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPHRATA EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "509-754-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0681290001",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030252",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raul P Dominguiano, MD
• Renee Christine Dormaier, LMP
• Dr. Tashauna Devine PLLC
• Rhonda Venise Edison, D.O.
• Ephrata Community Dental Clinic
• Ephrata Family Dentistry
• Ephrata Medical Center P.S.
• Ephrata School District
• Dolores Ford, MS, NCC, LMHCA
• Hans W Fredericksen, RPH

• All providers in Ephrata, WA
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.