Individual provider Active NPI

Jeffrey R Urness, OD

  • Optometrist
  • Kennewick, WA
National Provider Identifier
1770690679
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001684 Issued in WA
Practice address
8200 W Grandridge Blvd
Kennewick, WA 99336-1680
Phone
(509) 736-0826
Fax
(509) 735-6868
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00001684 WA Primary

Addresses

Primary practice location

8200 W Grandridge Blvd
Kennewick, WA 99336-1680

Mailing address

PO Box 1506
Chehalis, WA 98532-0409
Phone (360) 242-3008

Other identifiers 5

IdentifierTypeStateIssuer
410043347OtherIDRAIL ROAD MEDICARE
410043341OtherWARAIL ROAD MEDICARE
410045033OtherWARAIL ROAD MEDICARE
410022657OtherWARAIL ROAD MEDICARE
410045034OtherORRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060505000664 WA Practitioner - Optometry 0042221012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD00001684WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. Current Accepting new patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Eye Care Associates, PLLC Optometrist CurrentSince Jun 1, 2016 Accepting new patients

Locations

2822 S Vista Ave
Boise, ID 83705
Phone (208) 385-7576

250 W Bobwhite Ct
Ste 100
Boise, ID 83706
Phone (208) 385-7576

3330 4th St
Lewiston, ID 83501
Phone (208) 746-2025

19801 SW 72nd Ave
Ste 150
Tualatin, OR 97062
Phone (503) 691-2283

2517 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 748-8632

6695 W Rio Grande Ave
Kennewick, WA 99336
Phone (509) 736-0826

8200 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 736-0826

1103 N Pines Rd
Spokane Valley, WA 99206
Phone (509) 926-6800

16818 E Desmet Ct
Spokane Valley, WA 99216
Phone (360) 242-3008

2915 S Alder St
Tacoma, WA 98409
Phone (253) 473-0275

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1770690679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320409",
            "telephone_number": "360-242-3008",
            "fax_number": "360-807-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 W GRANDRIDGE BLVD",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361680",
            "telephone_number": "509-736-0826",
            "fax_number": "509-735-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URNESS",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410043347",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410043341",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410045033",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410022657",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410045034",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.