NPIMap

Organization Active NPI

Eyeglass Center

  • Optometrist
  • Grants Pass, OR
National Provider Identifier
1689742132
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4030T Issued in OR
Legal business name
EYEGLASS CENTER
Practice address
135 NE Terry LN
Grants Pass, OR 97526-4801
Phone
(541) 471-2070
Fax
(541) 582-2600
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tom Fickes, O.D.NPI 1427126986
Title
Owner
Phone
(541) 471-2070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4030T OR Primary

Addresses

Primary practice location

135 NE Terry LN
Grants Pass, OR 97526-4801

Mailing address

744 Forest Hills Dr
Rogue River, OR 97537-9664
Phone (541) 471-2070

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689742132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 FOREST HILLS DR",
            "city": "ROGUE RIVER",
            "state": "OR",
            "postal_code": "975379664",
            "telephone_number": "541-471-2070",
            "fax_number": "541-582-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 NE TERRY LN",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975264801",
            "telephone_number": "541-471-2070",
            "fax_number": "541-582-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEGLASS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FICKES",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-471-2070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4030T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.