Organization Active NPI

Soldotna Optometry Clinic, LLC

  • Optometrist
  • Soldotna, AK
National Provider Identifier
1942221221
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
#87 Issued in AK
Legal business name
SOLDOTNA OPTOMETRY CLINIC, LLC
Practice address
155 Smith Way
Suite 202
Soldotna, AK 99669-8060
Phone
(907) 262-3168
Fax
(907) 262-5458
NPI assigned
Jul 21, 2006
Last updated
Feb 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Dr. John A. Demske, O.D.
Title
Sole Owner
Phone
(907) 262-3168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X #87 AK Primary

Addresses

Primary practice location

155 Smith Way
Suite 202
Soldotna, AK 99669-8060

Mailing address

155 Smith Way
Suite 202
Soldotna, AK 99669-8060
Phone (907) 262-3168

National Provider Directory

National Provider Directory

Locations

155 Smith Way
Ste 202
Soldotna, AK 99669
Phone (907) 262-3168

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1942221221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 SMITH WAY",
            "address_2": "SUITE 202",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698060",
            "telephone_number": "907-262-3168",
            "fax_number": "907-262-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 SMITH WAY",
            "address_2": "SUITE 202",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698060",
            "telephone_number": "907-262-3168",
            "fax_number": "907-262-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLDOTNA OPTOMETRY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "DEMSKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "907-262-3168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "#87",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.