NPIMap

Organization Active NPI

Bear River Vision, PC

  • Optometrist
  • Soda Springs, ID
National Provider Identifier
1699717173
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0-536 Issued in ID
Legal business name
BEAR RIVER VISION, PC
Practice address
380 S 3Rd W
Soda Springs, ID 83276-1559
Phone
(208) 547-2114
NPI assigned
Jun 11, 2006
Last updated
Dec 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Dr. Terry H. Sanderson, O.D.NPI 1427099258
Title
Owner
Phone
(208) 547-2114

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
Optometrist 152W00000X 0-536 ID Primary

Addresses

Primary practice location

380 S 3Rd W
Soda Springs, ID 83276-1559

Mailing address

380 S 3Rd W
Soda Springs, ID 83276-1559
Phone (208) 547-2114

National Provider Directory

National Provider Directory

Locations

380 S 3rd W
Soda Springs, ID 83276
Phone (208) 547-2020

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1699717173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 S 3RD W",
            "city": "SODA SPRINGS",
            "state": "ID",
            "postal_code": "832761559",
            "telephone_number": "208-547-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 S 3RD W",
            "city": "SODA SPRINGS",
            "state": "ID",
            "postal_code": "832761559",
            "telephone_number": "208-547-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR RIVER VISION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "SANDERSON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-547-2114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "0-536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soda Springs, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.