Garland Vision Source, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3101TX Issued in WA

Legal business name

GARLAND VISION SOURCE, INC.

Practice address

521 W Garland Ave
Spokane, WA 99205-2954

Phone

(509) 327-9505

Fax

(509) 325-3277

NPI assigned

Nov 14, 2007

Organization subpart

No

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

Authorized official

Name

Shelley Kay Davis

Title

Accounts and Insurance Manager

Phone

(509) 327-9505

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Locations

Practitioners 3

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

• Jonathan Glennie, OD

  • Optometrist
  • Spokane, WA
  • NPI 1184463101
  Medicare reassignment Care Compare group NPD
• Brett Norman Hagen, O.D.

  • Optometrist
  • Spokane, WA
  • NPI 1518052091
  Medicare reassignment Care Compare group NPD
• Jezzarae Rose Hedlund, O.D.

  • Optometrist
  • Spokane, WA
  • NPI 1225383268
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1992986327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W GARLAND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992052954",
            "telephone_number": "509-327-9505",
            "fax_number": "509-325-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W GARLAND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992052954",
            "telephone_number": "509-327-9505",
            "fax_number": "509-325-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARLAND VISION SOURCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "ACCOUNTS AND INSURANCE MANAGER",
        "authorized_official_telephone_number": "509-327-9505"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3101TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U19693",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD RIDER",
            "identifier": "E08254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0145801",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024560",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawnee Gardner, CDP, LACSW
• Timothy John Gardner, MD
• Melanie Garduno
• Tamara Garduno, MD
• Garland Dictrict Counseling Services PLLC
• Sheree Garland, LPC
• Janel L Garlick, RPH
• Lynda Joy Garlick, CDP
• Scott B. Garlick, R. PH.
• Edward L Garman, MD

• Optometrist in Spokane, WA
• Providers in Spokane, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.