Organization Active NPI

Heaston Vision Clinic Inc PS

  • Optometrist
  • Richland, WA
National Provider Identifier
1972629871
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HEASTON VISION CLINIC INC PS
Practice address
1321 Aaron Dr
Richland, WA 99352-4678
Phone
(509) 943-3171
Fax
(509) 946-0905
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Authorized official

Name
Dr. Dale D Heaston, O.D.NPI 1003924374
Title
Owner
Phone
(509) 943-3171

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 Primary

Addresses

Primary practice location

1321 Aaron Dr
Richland, WA 99352-4678

Mailing address

PO Box 610
Richland, WA 99352-0610
Phone (509) 943-3171

Other identifiers 1

IdentifierTypeStateIssuer
410016629OtherWARAILROAD MEDICARE

Other names 1

  • Heaston & Thompson Vision Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040313000470 WA Part B Supplier - Clinic/Group Practice 0941199285 Receives reassigned benefits from 5 practitioners
Practice locations: Richland, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2070397Heaston and Thompson Vision Clinic1321 Aaron Dr, Richland, WA 99352Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

706 George Washington Way
Richland, WA 99352
Phone (509) 943-3171

Practitioners & affiliated clinicians

Practitioners 6

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1972629871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993520610",
            "telephone_number": "509-943-3171",
            "fax_number": "509-946-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 AARON DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524678",
            "telephone_number": "509-943-3171",
            "fax_number": "509-946-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEASTON VISION CLINIC INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "HEASTON",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-943-3171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410016629",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heaston & Thompson Vision Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.