Individual provider Active NPI

David A Cantley, OD

  • Optometrist
  • Richland, WA
National Provider Identifier
1689674863
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1755 Issued in WA
Practice address
112 Columbia Point Dr
Ste 102
Richland, WA 99352-4390
Phone
(509) 943-6565
Fax
(509) 946-6416
NPI assigned
Jul 28, 2005
Last updated
Nov 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1755 WA Primary

Addresses

Primary practice location

112 Columbia Point Dr
Ste 102
Richland, WA 99352-4390

Mailing address

112 Columbia Point Dr
Ste 102
Richland, WA 99352
Phone (509) 943-6565

Other identifiers 2

IdentifierTypeStateIssuer
2027985MedicaidWA
167571OtherWALABOR AND INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1755WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Vision and Optical Optometrist PastSince Jul 7, 2008 Accepting new patients
Heaston Vision Clinic Inc PS Optometrist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1689674863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 COLUMBIA POINT DR",
            "address_2": "STE 102",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-943-6565",
            "fax_number": "509-946-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 COLUMBIA POINT DR",
            "address_2": "STE 102",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524390",
            "telephone_number": "509-943-6565",
            "fax_number": "509-946-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTLEY",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2027985",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "167571",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.