Organization Active NPI

Dr. Kimberly Carr-Yeates, O.D., P.S.

  • Optometrist
  • Olympia, WA
National Provider Identifier
1881754182
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003197 Issued in WA
Legal business name
DR. KIMBERLY CARR-YEATES, O.D., P.S.
Practice address
625 Black Lake Blvd SW Ste 369
Olympia, WA 98502-8606
Phone
(360) 753-4533
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kimberly Carr-Yeates, O.D.
Title
Optometrist and Owner
Phone
(360) 753-4533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD00003197 WA Primary

Addresses

Primary practice location

625 Black Lake Blvd SW Ste 369
Olympia, WA 98502-8606

Mailing address

625 Black Lake Blvd SW Ste 369
Olympia, WA 98502-8606

National Provider Directory

National Provider Directory

Locations

1510 Cooper Point Rd SW
#110
Olympia, WA 98502
Phone (360) 489-0493

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881754182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BLACK LAKE BLVD SW STE 369",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BLACK LAKE BLVD SW STE 369",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028606",
            "telephone_number": "360-753-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KIMBERLY CARR-YEATES, O.D., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARR-YEATES",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OPTOMETRIST AND OWNER",
        "authorized_official_telephone_number": "360-753-4533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.