Revolution-Eyes LLC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

602967641 Issued in WA

Legal business name

REVOLUTION-EYES LLC

Practice address

215 E Broadway Ave
Moses Lake, WA 98837-1717

Phone

(509) 771-9342

Fax

(509) 765-0204

NPI assigned

Jan 11, 2010

Last updated

Jan 11, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin Douglas Osborne, O.D.NPI 1174656870

Title

Owner

Phone

(509) 771-9342

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin D Osborne, OD

  • Optometrist
  • Moses Lake, WA
  • NPI 1174656870
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1689904864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E BROADWAY AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371717",
            "telephone_number": "509-771-9342",
            "fax_number": "509-765-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E BROADWAY AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371717",
            "telephone_number": "509-771-9342",
            "fax_number": "509-765-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION-EYES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-771-9342",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "602967641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Reed
• Kaylee Regul, DPT
• Yvonne R Reigstad
• Brandon Justin Rendon
• Srinivasa Suri Repalle, RPH
• Yolanda Reyes, MSW
• Elizabeth Jean Reynolds, PA-C
• Robert Dale Reynolds Jr., CRNA
• Ribellia Chiropractic Enterprises PLLC (Life Wellness Chiropractic)
• Richard Lucian Ribellia, D.C.

• Corneal and Contact Management Optometrist in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Corneal and Contact Management Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.