Organization Active NPI

Bellingham Vision Clinic Inc

  • Optometrist
  • Bellingham, WA
National Provider Identifier
1801082391
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BELLINGHAM VISION CLINIC INC
Practice address
707 E Holly St
Bellingham, WA 98225-4712
Phone
(360) 752-2020
Fax
(360) 738-9741
NPI assigned
Sep 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Dr. Michael Steven Hovander, O.D.NPI 1548353303
Title
Owner
Phone
(360) 752-2020

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

707 E Holly St
Bellingham, WA 98225-4712

Mailing address

707 E Holly St
Bellingham, WA 98225-4712
Phone (360) 752-2020

Other identifiers 1

IdentifierTypeStateIssuer
2014892MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080409000164 WA Part B Supplier - Clinic/Group Practice 6406933837 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Ferndale, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

707 E Holly St
Bellingham, WA 98225
Phone (360) 752-2020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1801082391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E HOLLY ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254712",
            "telephone_number": "360-752-2020",
            "fax_number": "360-738-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E HOLLY ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254712",
            "telephone_number": "360-752-2020",
            "fax_number": "360-738-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLINGHAM VISION CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "HOVANDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-752-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2014892",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.