Salem Eye Clinic

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SALEM EYE CLINIC

Practice address

1097 Liberty St SE
Salem, OR 97302-4140

Phone

(503) 581-4411

Fax

(503) 581-2241

NPI assigned

Dec 13, 2007

Last updated

Jul 1, 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

Dr. Jordan D BrownNPI 1083613848

Title

Owner

Phone

(503) 581-4411

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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.

• Jordan David Brown, D.O.

  • Vision Therapy Optometrist
  • Salem, OR
  • NPI 1083613848
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1780867739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1097 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024140",
            "telephone_number": "503-581-4411",
            "fax_number": "503-581-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024140",
            "telephone_number": "503-581-4411",
            "fax_number": "503-581-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-581-4411",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Salem, OR
• Providers in Salem, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.