Optic Art III, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-552 Issued in ID

Legal business name

OPTIC ART III, PLLC

Practice address

213 N Main St
Moscow, ID 83843-2700

Phone

(208) 882-2932

NPI assigned

Jan 27, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Rodger Dean Robertson, O.D.NPI 1265503320

Title

Optometric Physician

Phone

(208) 882-2932

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rodger Dean Robertson, O.D.

  • Optometrist
  • Moscow, ID
  • NPI 1265503320
  NPD (past) Authorized official

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1851663512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N MAIN ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432700",
            "telephone_number": "208-882-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N MAIN ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432700",
            "telephone_number": "208-882-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIC ART III, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "RODGER",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "208-882-2932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805042600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas James Olps, LPC
• Jessica Olson
• Richard Ong, ATC, LAT
• Opportunities Unlimited, Inc.
• Optic Art II, P.C.
• Tina M Overstreet, SUDP
• Christine Owens
• Vanessa Nicole Padilla
• Lydia Pagel
• Tommia Pakootas

• Optometrist in Moscow, ID
• Providers in Moscow, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.