NPIMap

Organization Active NPI

San Juans Vision Care P.S.

Doing business as San Juans Vision Source

  • Clinic/Center
  • Eastsound, WA
National Provider Identifier
1932227154
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
OD00001839 Issued in WA
Legal business name
SAN JUANS VISION CARE P.S.
Doing business as
San Juans Vision Source
Practice address
1286 Suite 106 B Mt Baker Road
Eastsound, WA 98245
Phone
(360) 376-5310
Fax
(866) 393-7127
NPI assigned
Mar 26, 2007
Last updated
Jan 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Authorized official

Name
Dr. Christopher T White, ODNPI 1710020482
Title
President
Phone
(360) 376-5310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X OD00001839 WA Primary

Addresses

Primary practice location

1286 Suite 106 B Mt Baker Road
Eastsound, WA 98245

Mailing address

PO Box 181
Eastsound, WA 98245
Phone (360) 376-5310

Other names 1

  • San Juans Vision Source Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080610000084 WA Part B Supplier - Clinic/Group Practice 9638249154 Receives reassigned benefits from 1 practitioner
Practice locations: Eastsound, WA

National Provider Directory

National Provider Directory

Locations

1286 Mount Baker Rd
Ste B106
Eastsound, WA 98245
Phone (360) 376-5310

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1932227154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 181",
            "city": "EASTSOUND",
            "state": "WA",
            "postal_code": "98245",
            "telephone_number": "360-376-5310",
            "fax_number": "866-393-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 SUITE 106 B MT BAKER ROAD",
            "city": "EASTSOUND",
            "state": "WA",
            "postal_code": "98245",
            "telephone_number": "360-376-5310",
            "fax_number": "866-393-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUANS VISION CARE P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-376-5310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "OD00001839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Juans Vision Source",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eastsound, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.