JD Harris PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1863T Issued in OR

Legal business name

JD HARRIS PC

Doing business as

Beaverton Vision World

Practice address

11020 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3007

Phone

(503) 789-6720

Fax

(503) 644-8330

NPI assigned

Nov 9, 2007

Organization subpart

No

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

Authorized official

Name

Irene Ernestina Olivieri-Harris

Title

Corporate Secretary/Business Manage

Phone

(503) 526-9697

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Beaverton Vision World Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 6

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.

• Jeffrey Donald Harris, O.D.

  • Optometrist
  • Beaverton, OR
  • NPI 1629046818
  Medicare reassignment Care Compare group NPD
• Jannie Lee, OD

  • Optometrist
  • Portland, OR
  • NPI 1609218163
  Medicare reassignment Care Compare group NPD
• Alexandra Bavasi, O.D.

  • Optometrist
  • Forest Grove, OR
  • NPI 1720330061
  Medicare reassignment NPD
• Olesya Viestenz

  • Optometrist
  • Tigard, OR
  • NPI 1841509924
  Medicare reassignment NPD
• Sara Renee Williams, OD

  • Optometrist
  • Beaverton, OR
  • NPI 1528009792
  NPD (past)
• Mark Yost

  • Optometrist
  • Tigard, OR
  • NPI 1821713645
  NPD (past)

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1801076542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11020 SW BEAVERTON HILLSDALE HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053007",
            "telephone_number": "503-526-9697",
            "fax_number": "503-644-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 SW BEAVERTON HILLSDALE HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053007",
            "telephone_number": "503-789-6720",
            "fax_number": "503-644-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JD HARRIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "OLIVIERI-HARRIS",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "ERNESTINA",
        "authorized_official_title_or_position": "CORPORATE SECRETARY/BUSINESS MANAGE",
        "authorized_official_telephone_number": "503-526-9697"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1863T",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500614131",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaverton Vision World",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Janssen
• Molly Kay Jarvis
• Nancy Ann Jauch, M.D.
• Gil Ilustre Javelosa Jr., PT
• Rushini K. Jayawardena, MSW
• Heather Lucile Jeffers, LMT
• Susan Jeltsch
• Amanda Noelle Jenkins
• Randi Jenkins
• Jennifer Means ND Lac PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.