Jamison Riley Soupir, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4328AT Issued in OR

Practice address

2043 College Way
Forest Grove, OR 97116-1756

Phone

(503) 352-3197

NPI assigned

Aug 4, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Grande Family Eye CareGroup PAC ID 7012069016, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• La Grande Family Eye Care

  • Eyewear Supplier
  • La Grande, OR
  • NPI 1376773960

  Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952826513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161756",
            "telephone_number": "503-352-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161756",
            "telephone_number": "503-352-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUPIR",
        "first_name": "JAMISON",
        "middle_name": "RILEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4328AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Smith
• Kelvin Kiu Wing So, O.D.
• Jaclyn Sorbets
• Paul E Sorenson, LCSW
• Karen Anne Sotto, L.M.T.
• Timothy Allen Speck, O.D.
• Emily Anne Sproul, MS CCC-SLP
• Paige Elise Stahle
• Stephanie Haugen LLC
• Sean Lincoln Steward, MD

• Optometrist in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.