NPIMap

Organization Active NPI

Newberg Vision Clinic, P.C.

  • Optometrist
  • Newberg, OR
National Provider Identifier
1699973180
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3200ATI Issued in OR
Legal business name
NEWBERG VISION CLINIC, P.C.
Practice address
2207 Portland Rd Ste a
Newberg, OR 97132-1371
Phone
(503) 538-3277
NPI assigned
Jul 5, 2007
Last updated
Sep 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Authorized official

Name
Dr. Paula A Taylor, O.D.NPI 1932297371
Title
Secretary Treasurer
Phone
(503) 487-7658

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 3200ATI OR Primary

Addresses

Primary practice location

2207 Portland Rd Ste a
Newberg, OR 97132-1371

Mailing address

2207 Portland Rd Ste a
Newberg, OR 97132-1371
Phone (503) 538-3277

Other identifiers 2

IdentifierTypeStateIssuer
006217MedicaidOR
R138510OtherORMEDICARE PTAN

Other names 1

  • Taylor Family Eye Care, P.C. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070730000446 OR Part B Supplier - Clinic/Group Practice 1456452838 Receives reassigned benefits from 2 practitioners
Practice locations: Newberg, OR

National Provider Directory

National Provider Directory

Locations

2207 E Portland Rd
Ste A
Newberg, OR 97132
Phone (503) 538-3277

Practitioners & affiliated clinicians

Practitioners 3

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": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253145600000",
    "number": "1699973180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 PORTLAND RD STE A",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321371",
            "telephone_number": "503-538-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 PORTLAND RD STE A",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321371",
            "telephone_number": "503-538-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERG VISION CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2009-09-17",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY TREASURER",
        "authorized_official_telephone_number": "503-487-7658",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3200ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006217",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R138510",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taylor Family Eye Care, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Newberg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.