Hawks Prairie Vision Clinic, P.S.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

OD00003048 Issued in WA

Legal business name

HAWKS PRAIRIE VISION CLINIC, P.S.

Practice address

2539 Marvin Rd NE Ste B
Lacey, WA 98516-3175

Phone

(360) 459-3333

Fax

(360) 459-2724

NPI assigned

Dec 5, 2007

Last updated

Oct 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Connie Lee Piranio, O.D.

Title

Doctor

Phone

(360) 459-3333

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

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.

• Jenni Rubio Aaseby, O.D.

  • Optometrist
  • Shelton, WA
  • NPI 1720133374
  Medicare reassignment NPD
• Michelle Renee Durham, O.D.

  • Optometrist
  • Lacey, WA
  • NPI 1023287067
  Medicare reassignment NPD

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1952583536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 MARVIN RD NE SUITE B",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "98516",
            "telephone_number": "360-459-3333",
            "fax_number": "360-459-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 MARVIN RD NE STE B",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985163175",
            "telephone_number": "360-459-3333",
            "fax_number": "360-459-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWKS PRAIRIE VISION CLINIC, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "PIRANIO",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "360-459-3333",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "OD00003048",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF2770",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025922",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Lee Hatt, ARNP
• Hunter Michael Hatton
• Dirk Francis Havlak, MD
• Hawks Prairie Pharmacy (Hawks Prairie Health Mart Pharmacy)
• Hawks Prairie Pharmacy (Hawks Prairie Health Mart Pharmacy)
• Lauren E Hawks
• Joanna Haws, O.D.
• Hope Marie Hayes, LMHCA
• Mindy M Hayes, LMP
• Sarah Hayes

• Preferred Provider Organization in Lacey, WA
• Providers in Lacey, WA by specialty
• Preferred Provider Organization in Washington

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