Medical Vision Center, LTD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00000957 Issued in WA

Legal business name

MEDICAL VISION CENTER, LTD

Practice address

240 W. Main St.
Morton, WA 98356

Phone

(360) 496-5140

Fax

(360) 496-6039

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Donald A Carroll, O.D.NPI 1265433510

Title

Owner

Phone

(360) 496-5140

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 4

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

• Donald A Carroll, O.D.

  • Optometrist
  • Morton, WA
  • NPI 1265433510
  Medicare reassignment Authorized official
• Tammy L Johnson, OPTICIAN

  • Optician
  • Longview, WA
  • NPI 1326180076
  NPD (past)
• Stephanie R Sipe, OD

  • Optometrist
  • Longview, WA
  • NPI 1740225077
  NPD (past)
• Jamal Masalmeh, O.D.

  • Optometrist
  • Portland, OR
  • NPI 1417071861
  NPD (past)

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861697070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W. MAIN ST.",
            "address_2": "P.O. BOX AC",
            "city": "MORTON",
            "state": "WA",
            "postal_code": "98356",
            "telephone_number": "360-496-5140",
            "fax_number": "360-496-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W. MAIN ST.",
            "city": "MORTON",
            "state": "WA",
            "postal_code": "98356",
            "telephone_number": "360-496-5140",
            "fax_number": "360-496-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL VISION CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-496-5140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00000957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018240",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lewis County Hospital District No. 1
• Lewis County Hospital District No. 1
• Lewis County Hospital District No. 1
• Pamela Lynn Logalbo, RN
• Kevin W. McCurry, M.D.
• Jennifer Montoure, ARNP, FNP-C
• Morton Chiropractic Center PLLC
• Morton School District
• Todd Gordon Nelson, CRNA
• New Era Denture Service

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.