NPIMap

Organization Active NPI

Brian E. Elliott, O.D.

Doing business as Riverbank Optometric Center

  • Optometrist
  • Riverbank, CA
National Provider Identifier
1851528236
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9440T Issued in CA
Legal business name
BRIAN E. ELLIOTT, O.D.
Doing business as
Riverbank Optometric Center
Practice address
6331 Jackson Ave
Riverbank, CA 95367-2733
Phone
(209) 869-3300
Fax
(209) 869-8809
NPI assigned
Jun 12, 2009
Last updated
Jun 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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

Authorized official

Name
Mr. Brian E Elliott, O.D.NPI 1760566434
Title
Owner
Phone
(209) 869-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 9440T CA Primary

Addresses

Primary practice location

6331 Jackson Ave
Riverbank, CA 95367-2733

Mailing address

6331 Jackson Ave
Riverbank, CA 95367-2733
Phone (209) 869-3300

Other names 1

  • Riverbank Optometric Center Doing business as

National Provider Directory

National Provider Directory

Locations

6331 Jackson Ave
Riverbank, CA 95367
Phone (209) 869-3300

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244764800000",
    "number": "1851528236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 JACKSON AVE",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953672733",
            "telephone_number": "209-869-3300",
            "fax_number": "209-869-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 JACKSON AVE",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953672733",
            "telephone_number": "209-869-3300",
            "fax_number": "209-869-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN E. ELLIOTT, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-12",
        "last_updated": "2009-06-12",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-869-3300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9440T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverbank Optometric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.