NPIMap

Organization Active NPI

Hawthorne Vision Center PC

  • Optometrist
  • Portland, OR
National Provider Identifier
1770699860
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HAWTHORNE VISION CENTER PC
Practice address
4704 SE Hawthorne Blvd
Portland, OR 97215
Phone
(503) 235-6639
Fax
(503) 235-2263
NPI assigned
Aug 22, 2006
Last updated
Jun 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Mrs. Rebecca A Uhlig, ODNPI 1821023326
Title
Owner
Phone
(503) 235-6639

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 NU Primary

Addresses

Primary practice location

4704 SE Hawthorne Blvd
Portland, OR 97215

Mailing address

4704 SE Hawthorne Blvd
Portland, OR 97215
Phone (503) 235-6639

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414000363 OR Part B Supplier - Clinic/Group Practice 3476547985 Receives reassigned benefits from 4 practitioners
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

4704 SE Hawthorne Blvd
Portland, OR 97215
Phone (503) 235-6639

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1770699860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97215",
            "telephone_number": "503-235-6639",
            "fax_number": "503-235-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4704 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97215",
            "telephone_number": "503-235-6639",
            "fax_number": "503-235-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWTHORNE VISION CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "UHLIG",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-235-6639",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.