NPIMap

Organization Active NPI

Wayne L Gerig OD

  • Optometrist
  • Tigard, OR
National Provider Identifier
1679744148
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1478AT Issued in OR
Legal business name
WAYNE L GERIG OD
Practice address
10225 SW Hall Blvd
Ste 101
Tigard, OR 97223-8855
Phone
(503) 244-1004
Fax
(503) 244-1006
NPI assigned
Mar 12, 2008
Organization subpart
Yes
Parent organization
WAYNE L GERIGAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Authorized official

Name
Dr. Wayne L Gerig, OD
Title
Owner
Phone
(503) 244-1004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1478AT OR Primary

Addresses

Primary practice location

10225 SW Hall Blvd
Ste 101
Tigard, OR 97223-8855

Mailing address

10225 SW Hall Blvd Ste 101
Tigard, OR 97223-8855
Phone (503) 244-1004

Other identifiers 1

IdentifierTypeStateIssuer
283135MedicaidOR

Other names 1

  • 20/20 EYECARE PROFESSIONALS Doing business as

National Provider Directory

National Provider Directory
Part of
Wayne L Gerig OD

Locations

10225 SW Hall Blvd
Ste 101
Tigard, OR 97223
Phone (503) 244-1004

29990 SW Town Center Loop W
#8
Wilsonville, OR 97070
Phone (503) 684-1410

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1679744148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10225 SW HALL BLVD STE 101",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238855",
            "telephone_number": "503-244-1004",
            "fax_number": "503-244-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 SW HALL BLVD",
            "address_2": "STE 101",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238855",
            "telephone_number": "503-244-1004",
            "fax_number": "503-244-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE L GERIG OD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAYNE L GERIG",
        "enumeration_date": "2008-03-12",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "GERIG",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-244-1004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1478AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283135",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "20/20 EYECARE PROFESSIONALS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.