North Idaho Eye Clinics, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100109 Issued in ID

Legal business name

NORTH IDAHO EYE CLINICS, INC

Doing business as

1. Lakeland Eye Clinic 2. Kellogg Vision Center

Practice address

15630 N Highway 41
Rathdrum, ID 83858-8710

Phone

(208) 687-0370

Fax

(208) 687-0470

NPI assigned

Jan 25, 2007

Last updated

Mar 14, 2008By 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

Dr. Brian R Miller, O.D.NPI 1710978473

Title

President

Phone

(208) 687-0370

Specialties & licenses 1

Addresses

Other names 1

• 1. Lakeland Eye Clinic 2. Kellogg Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

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.

• Brian Richard Miller, OD

  • Optometrist
  • Rathdrum, ID
  • NPI 1710978473
  Medicare reassignment Care Compare group NPD Authorized official
• Brian Paul Finley, O.D.

  • Optometrist
  • Hayden, ID
  • NPI 1649571118
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1972658169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15630 N HIGHWAY 41",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838588710",
            "telephone_number": "208-687-0370",
            "fax_number": "208-687-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15630 N HIGHWAY 41",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838588710",
            "telephone_number": "208-687-0370",
            "fax_number": "208-687-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH IDAHO EYE CLINICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-687-0370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1. Lakeland Eye Clinic 2. Kellogg Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy C Morse, MD
• Mark Jonathan Mosemann, M.D.
• Natashia M Nelson, ARNP
• Matthew David Nordlie, DMD
• North Idaho Day Surgery LLC
• On the Go Pediatric Therapy LLC
• Osburn Drug Co (Rathdrum Drug)
• Jeffrey Lee Oswell, D.M.D.
• Kimberly K Palmer, LM CPM
• Michelle Marie Parks

• Optometrist in Rathdrum, ID
• Providers in Rathdrum, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.