Benson Vision Source, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003501 Issued in WA

Legal business name

BENSON VISION SOURCE, INC.

Practice address

25022 104TH Ave SE Ste D
Kent, WA 98030-2822

Phone

(253) 859-1911

Fax

(253) 859-5084

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Thomas L Mitchell, O.D.

Title

President

Phone

(253) 859-1911

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 5

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

• Tapuwa Chikwinya

  • Optometrist
  • Federal Way, WA
  • NPI 1063909935
  NPD
• Kurt James Hofeldt, OD

  • Optometrist
  • Kent, WA
  • NPI 1962739912
  NPD
• Jordan E Jin, OD

  • Optometrist
  • Bellevue, WA
  • NPI 1659930170
  NPD
• Robert Keil Neal, O.D.

  • Optometrist
  • Maple Valley, WA
  • NPI 1376632539
  NPD
• Adrian Salamanca, O.D.

  • Optometrist
  • Seattle, WA
  • NPI 1710239058
  NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1679601512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25022 104TH AVE SE STE D",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980302822",
            "telephone_number": "253-859-1911",
            "fax_number": "253-859-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25022 104TH AVE SE STE D",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980302822",
            "telephone_number": "253-859-1911",
            "fax_number": "253-859-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENSON VISION SOURCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-859-1911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2026748",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Bender
• Mykala Benjamin
• Kelly Kimberly Bennett-Aurdahl, LCSW
• Zoey Bennett
• Rozanne Benoschek, LPN
• Macey Royann Bentley, LA,LMP
• Melissa Suzanne Berens, LMT
• Jennifer Jade Berg
• William Bergendahl
• Evgeniya Berger, NP

• Optometrist in Kent, WA
• Providers in Kent, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.