Organization Active NPI

Paradocs, Inc. PS

  • Optometrist
  • Walla Walla, WA
National Provider Identifier
1891999173
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001914 Issued in WA
Legal business name
PARADOCS, INC. PS
Practice address
1711 Dalles Military Rd
Walla Walla, WA 99362-8028
Phone
(509) 529-1153
Fax
(509) 529-8812
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Authorized official

Name
Dr. Rosanne F Schneller, O.D.
Title
Owner
Phone
(509) 529-1153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD00001914 WA Primary

Addresses

Primary practice location

1711 Dalles Military Rd
Walla Walla, WA 99362-8028

Mailing address

1711 Dalles Military Rd
Walla Walla, WA 99362-8028
Phone (509) 529-1153

Other identifiers 1

IdentifierTypeStateIssuer
2017887MedicaidWA

Other names 1

  • Blue Mountain Vision Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000501 WA Part B Supplier - Clinic/Group Practice 7810885571 Practice locations: Walla Walla, WA

National Provider Directory

National Provider Directory

Locations

614 E Alder St
Ste 1
Walla Walla, WA 99362
Phone (509) 527-3937

1711 Dalles Military Rd
Walla Walla, WA 99362
Phone (509) 529-1153

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1891999173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 DALLES MILITARY RD",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993628028",
            "telephone_number": "509-529-1153",
            "fax_number": "509-529-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 DALLES MILITARY RD",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993628028",
            "telephone_number": "509-529-1153",
            "fax_number": "509-529-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADOCS, INC. PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "SCHNELLER",
        "authorized_official_first_name": "ROSANNE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-529-1153",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017887",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Mountain Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.