Coos Bay Vision Center, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

1992ATI Issued in OR

Legal business name

COOS BAY VISION CENTER, INC

Practice address

986 Central Ave
Coos Bay, OR 97420-1736

Phone

(541) 267-4224

Fax

(541) 269-7357

NPI assigned

Nov 27, 2007

Last updated

Nov 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patricia B Gates, ODNPI 1255317665

Title

President

Phone

(541) 267-4224

Specialties & licenses 7

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 3

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.

• Patricia B Gates, OD

  • Optometrist
  • Coos Bay, OR
  • NPI 1255317665
  Medicare reassignment Care Compare group NPD Authorized official
• Ashley Nicole Calvert, OD

  • Optometrist
  • Astoria, OR
  • NPI 1104486356
  Medicare reassignment Care Compare group NPD
• John Paul Reslock, O.D.

  • Optometrist
  • Coquille, OR
  • NPI 1356309645
  NPD (past)

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1851573323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 329",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974200034",
            "telephone_number": "541-267-4224",
            "fax_number": "541-269-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986 CENTRAL AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201736",
            "telephone_number": "541-267-4224",
            "fax_number": "541-269-7357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOS BAY VISION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-267-4224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1992ATI",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OR",
            "license": "1992ATI",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "OR",
            "license": "1992ATI",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OR",
            "license": "1992ATI",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "OR",
            "license": "1992ATI",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OR",
            "license": "1992ATI",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "OR",
            "license": "1992ATI",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015359",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coos Bay of Cascadia, LLC
• Coos Bay Rehabilitation, Inc.
• Coos Bay Rehabilitation, LLC (Avamere Rehabilitation of Coos Bay)
• Coos Bay School District 9
• Coos Bay Vision Center
• Coos Clinic LLC (Coos Clinic)
• Coos County Oregon
• Coos County Oregon
• Coos County Oregon (Coos Health & Wellness)
• Coos Radiosurgery Group LLC

• Optometrist in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.