Northeastern Washington Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

NORTHEASTERN WASHINGTON EYECARE

Doing business as

Colville Vision Source

Practice address

102 S Oak St
Colville, WA 99114-2846

Phone

(509) 684-5278

Fax

(509) 684-3268

NPI assigned

Mar 25, 2022

Last updated

Mar 25, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

NORTHEASTERN WASHINGTON EYECAREAs reported in NPPES

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

Authorized official

Name

Kyle Crance, ODNPI 1114372000

Title

Owner Doctor

Phone

(509) 844-1343

Specialties & licenses 1

Addresses

Other names 1

• Colville Vision Source Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Northeastern Washington Eyecare2 organizations share this tax ID, including this one

Part of

Northeastern Washington Eyecare

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northeastern Washington Eyecare

  dba Colville Vision Source

  • Optometrist
  • Newport, WA
  • NPI 1629638929
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Northeastern Washington Eyecare

  dba Colville Vision Source

  • Optometrist
  • Newport, WA
  • NPI 1629638929
  NPPES parent name

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.

• Kyle Crance, OD

  • Optometrist
  • Newport, WA
  • NPI 1114372000
  NPD Authorized official

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1811647605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S OAK ST",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142846",
            "telephone_number": "509-684-5278",
            "fax_number": "509-684-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S OAK ST",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142846",
            "telephone_number": "509-684-5278",
            "fax_number": "509-684-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN WASHINGTON EYECARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEASTERN WASHINGTON EYECARE",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "CRANCE",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "509-844-1343",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "colville@neweye.vision",
            "affiliation": "N",
            "endpointDescription": "E-Mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "102 S Oak St",
            "city": "Colville",
            "state": "WA",
            "country_code": "US",
            "postal_code": "991142846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Colville Vision Source",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Colville, WA
• Providers in Colville, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.