Active NPI
Longview Eye & Vision
- Optometrist
- Cathlamet, WA
National Provider Identifier
1811023732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- LONGVIEW EYE & VISION
- Practice address
- 180 3Rd Street
Cathlamet, WA 98612 - Phone
- (360) 795-3223
- Fax
- (360) 795-0738
- NPI assigned
- Feb 26, 2007
- Organization subpart
- Yes
- Parent organization
- CATHLAMET EYE & VISION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Terence Ormal Tack, OD
- Title
- Optometrist-Owner
- Phone
- (360) 795-3223
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary | ||
| Corneal and Contact Management Optometrist | 152WC0802X | |||
| Low Vision Rehabilitation Optometrist | 152WL0500X | |||
| Pediatric Optometrist | 152WP0200X | |||
| Sports Vision Optometrist | 152WS0006X | |||
| Vision Therapy Optometrist | 152WV0400X | |||
| Occupational Vision Optometrist | 152WX0102X |
Addresses
Primary practice location
180 3Rd Street
Cathlamet, WA 98612
Mailing address
PO Box 399
Cathlamet, WA 98612-0399
Phone (360) 795-3223
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410005544 | Other | WA | RAIL ROAD MEDICARE |
| 2027118 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Jeffery S Tack OD
- Part of
- Jeffery S Tack OD
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Longview, WA
- NPI 1861535197
-
- Optometrist
- Woodland, WA
- NPI 1215063516
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Longview, WA
- NPI 1558093591
-
- Optometrist
- Brush Prairie, WA
- NPI 1386953461
-
- Optometrist
- Longview, WA
- NPI 1386878965
-
- Optometrist
- Longview, WA
- NPI 1568839231
-
- Optometrist
- Longview, WA
- NPI 1710046610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1365379200000",
"number": "1811023732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 399",
"city": "CATHLAMET",
"state": "WA",
"postal_code": "986120399",
"telephone_number": "360-795-3223",
"fax_number": "360-795-0738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 3RD STREET",
"city": "CATHLAMET",
"state": "WA",
"postal_code": "98612",
"telephone_number": "360-795-3223",
"fax_number": "360-795-0738"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONGVIEW EYE & VISION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CATHLAMET EYE & VISION",
"enumeration_date": "2007-02-26",
"last_updated": "2013-04-08",
"status": "A",
"authorized_official_last_name": "TACK",
"authorized_official_first_name": "TERENCE",
"authorized_official_middle_name": "ORMAL",
"authorized_official_title_or_position": "OPTOMETRIST-OWNER",
"authorized_official_telephone_number": "360-795-3223",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Corneal and Contact Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WL0500X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Sports Vision",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WV0400X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Vision Therapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Occupational Vision",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "410005544",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2027118",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cathlamet, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; 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.