NPIMap

Organization Active NPI

Innervision Optometric Inc.

  • Optometrist
  • Wilsonville, OR
National Provider Identifier
1962534578
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
00004483 Issued in OR
Legal business name
INNERVISION OPTOMETRIC INC.
Practice address
8269 SW Wilsonville Rd Ste G
Wilsonville, OR 97070-7719
Phone
(503) 685-9015
Fax
(503) 682-8696
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Authorized official

Name
Dr. Rosiland Hursh, ODNPI 1225020910
Title
Owner
Phone
(503) 685-9015

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 00004483 OR Primary

Addresses

Primary practice location

8269 SW Wilsonville Rd Ste G
Wilsonville, OR 97070-7719

Mailing address

8269 SW Wilsonville Rd Ste G
Wilsonville, OR 97070-7719
Phone (503) 685-9015

Other names 1

  • Eye to Eye Clinic Wilsonville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040521000817 OR Part B Supplier - Clinic/Group Practice 2567453160 Receives reassigned benefits from 6 practitioners
Practice locations: Wilsonville, OR

National Provider Directory

National Provider Directory

Locations

8269 SW Wilsonville Rd
Ste G
Wilsonville, OR 97070
Phone (503) 685-9015

8269 SW Wilsonville Rd
Ste C
Wilsonville, OR 97070
Phone (503) 685-9015

Interoperability endpoints

  • FHIR API: https://eyetoeyewilsonville.ef.prod.fhir.ema-api.com/fhir/r4/

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1962534578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8269 SW WILSONVILLE RD STE G",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970707719",
            "telephone_number": "503-685-9015",
            "fax_number": "503-682-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8269 SW WILSONVILLE RD STE G",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970707719",
            "telephone_number": "503-685-9015",
            "fax_number": "503-682-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERVISION OPTOMETRIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "HURSH",
        "authorized_official_first_name": "ROSILAND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-685-9015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "00004483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye to Eye Clinic Wilsonville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye to Eye Clinic Wilsonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.