NPIMap

Organization Active NPI

Spokane Optical Company LLC

  • Eyewear Supplier
  • Spokane, WA
National Provider Identifier
1922006758
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
602382529 Issued in WA
Legal business name
SPOKANE OPTICAL COMPANY LLC
Doing business as
Spokane Optical Company, LLC
Practice address
427 S Bernard St
Spokane, WA 99204-2509
Phone
(509) 456-0107
Fax
(509) 747-2635
NPI assigned
Jul 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Authorized official

Name
Janis Simpson
Title
Ceo
Phone
(509) 456-0107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 602382529 WA Primary

Addresses

Primary practice location

427 S Bernard St
Spokane, WA 99204-2509

Mailing address

427 S Bernard St
Spokane, WA 99204-2509
Phone (509) 456-0107

Other identifiers 3

IdentifierTypeStateIssuer
1922006758MedicaidID
1922006758MedicaidWA
10803OtherWALABOR AND INDUSTRIES

Other names 1

  • Spokane Optical Company, LLC Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Spokane Eye Clinic427 S Bernard St, Spokane, WA 99204-2509(509) 456-0107 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1922006758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 S BERNARD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042509",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 S BERNARD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042509",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOKANE OPTICAL COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "JANIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-456-0107"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WA",
            "license": "602382529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922006758",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922006758",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "10803",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spokane Optical Company, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.