NPIMap

Organization Active NPI

Spec'D Out Eye Care, PS

  • Optometrist
  • Battle Ground, WA
National Provider Identifier
1821896531
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SPEC'D OUT EYE CARE, PS
Practice address
101 NW 12TH Ave Ste 101
Battle Ground, WA 98604-9145
Phone
(360) 687-0755
Fax
(360) 666-8664
NPI assigned
Mar 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Authorized official

Name
Derik Hardesty, ODNPI 1003497058
Title
Owner
Phone
(360) 687-0755

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

101 NW 12TH Ave Ste 101
Battle Ground, WA 98604-9145

Mailing address

101 NW 12TH Ave Ste 101
Battle Ground, WA 98604-9145
Phone (360) 687-0755

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250521003451 WA Part B Supplier - Clinic/Group Practice 8820511066 Receives reassigned benefits from 1 practitioner
Practice locations: Battle Ground, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1741219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1821896531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NW 12TH AVE STE 101",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049145",
            "telephone_number": "360-687-0755",
            "fax_number": "360-666-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NW 12TH AVE STE 101",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049145",
            "telephone_number": "360-687-0755",
            "fax_number": "360-666-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEC'D OUT EYE CARE, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-06",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "HARDESTY",
        "authorized_official_first_name": "DERIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-687-0755",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Ground, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; 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.