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1013964113 NPI number — EYECARE ASSOCIATES PC

NPI Number: 1013964113
Health Care Provider/Practitioner: EYECARE ASSOCIATES PC

Information about “1013964113” NPI (EYECARE ASSOCIATES PC) exists in 1013964113 in HTML format HTML  |  1013964113 in plain Text format TXT  |  1013964113 in PDF (Portable Document Format) PDF  |  1013964113 in an XML format XML  formats.

NPI Number : 1013964113 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013964113",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "EYECARE ASSOCIATES PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2715 WILLETTA ST SW STE B",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALBANY",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97321-3471",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "541-926-5848",
    "MailingAddressFaxNumber": "541-926-2873",
    "FirstLinePracticeLocationAddress": "2715 WILLETTA ST SW STE B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALBANY",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97321",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "541-926-5848",
    "PracticeLocationAddressFaxNumber": "541-926-2873",
    "EnumerationDate": "05/27/2006",
    "LastUpdateDate": "04/01/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MADSEN",
    "AuthorizedOfficialFirstName": "BRUCE",
    "AuthorizedOfficialMiddleName": "W",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "541-926-5848",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207W00000X",
          "TaxonomyName": "Ophthalmology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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