Organization Active NPI

Rogue Family Eye Care

  • Optometrist
  • Grants Pass, OR
National Provider Identifier
1982181186
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2980ATI Issued in OR
Legal business name
ROGUE FAMILY EYE CARE
Practice address
853 NE a St
Grants Pass, OR 97526
Phone
(541) 218-9966
NPI assigned
Jul 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Dr. Matthew Scot Richardson, ODNPI 1033211230
Title
President, Optometric Physician
Phone
(541) 474-2788

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2980ATI OR Primary
Pediatric OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WP0200X 2980ATI OR
Sports Vision OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WS0006X
Vision Therapy OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WV0400X 2980ATI OR

Addresses

Primary practice location

853 NE a St
Grants Pass, OR 97526

Mailing address

853 NE a St
Grants Pass, OR 97526-2211
Phone (541) 218-9966

Other identifiers 1

IdentifierTypeStateIssuer
2980ATIOtherOROREGON BOARD OF OPTOMETRY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address reception@roguefamilyeyecare.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180905002660 OR Part B Supplier - Clinic/Group Practice 9830449214 Receives reassigned benefits from 2 practitioners
Practice locations: Grants Pass, OR

National Provider Directory

National Provider Directory

Locations

853 NE A St
Grants Pass, OR 97526
Phone (541) 218-9966

Practitioners & affiliated clinicians

Practitioners 2

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": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1982181186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 NE A ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262211",
            "telephone_number": "541-218-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 NE A ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-218-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE FAMILY EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "SCOT",
        "authorized_official_title_or_position": "PRESIDENT, OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "541-474-2788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2980ATI",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "OR",
            "license": "2980ATI",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "OR",
            "license": "2980ATI",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON BOARD OF OPTOMETRY",
            "identifier": "2980ATI",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "reception@roguefamilyeyecare.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "853 NE A St",
            "city": "Grants Pass",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975262211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.