LIFETIME VISION CARE (NPI# 1508961731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508961731 |
| Entity Type | Organization |
| Organization Name | LIFETIME VISION CARE |
| Practice Address |
901 Nw Carlon Ave Suite 2 Bend OR 97703-2636 |
| Practice Telephone | 5413823242 |
| Practice Fax Number | 5413173579 |
| Mailing Telephone | 5413823242 |
| Mailing Fax Number | 5413173579 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2015-07-14 |
| Authorized Official Name | DERRI SANDBERG (OWNER) |
| Authorized Official Telephone | 5413823242 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3213ATI | OR | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MEDICARE PTAN | R163759 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871733535 | Lifetime Vision Care | Eyewear Supplier (Equipment, not the service) | 119 Summit St, Celina, OH 45822-1023 | 2009-02-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LIFETIME VISION CARE, LLC | 901 Nw Carlon Ave Ste 2, Bend, OR 97701 |
| Street Address |
901 NW CARLON AVE SUITE 2 |
| City | BEND |
| State | OR |
| Zip Code | 97703-2636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386626414 | Kari Szukalski | Physical Therapist | 901 Nw Carlon Ave, Ste 3, Bend, OR 97701-2636 | 2005-11-15 |
| 1215355359 | Katherine Stahrr | Dentist | 901 Nw Carlon Ave, Suite #1, Bend, OR 97703-2636 | 2014-04-05 |
| 1073886412 | Lifetime Vision Care LLC | Clinic/Center | 901 Nw Carlon Ave, Suite 2, Bend, OR 97703-2636 | 2012-02-15 |
| 1962787010 | Daniela Minnis | Optometrist | 901 Nw Carlon Ave, Bend, OR 97703-2636 | 2011-10-19 |
| 1881841781 | Brock Karben | Optometrist | 901 Nw Carlon Ave, Bend, OR 97703-2636 | 2008-08-21 |
| 1134269434 | Alison Jane Cobb | Physical Therapist | 901 Nw Carlon Ave, Suite 3, Bend, OR 97701-2636 | 2007-02-07 |
| 1154435162 | Carl John Ryan | Optometrist | 901 Nw Carlon Ave, Suite 2, Bend, OR 97703-2636 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285250704 | Elizabeth Jane Lindt | Counselor | 63311 Jamison Street, Bend, OR 97703 | 2020-06-20 |
| 1790318145 | Leah Alice Williamson | Counselor | 118 Nw Thurston Ave, Bend, OR 97703 | 2020-02-13 |
| 1831658301 | Pretty Moments Lingerie, LLC | Durable Medical Equipment & Medical Supplies | 63455 N Hwy 97 Suite 44, Bend, OR 97703 | 2019-03-14 |
| 1821561150 | Kevin Hallmeyer | Chiropractor | 750 Nw Charbonneau St., Suite 101, Bend, OR 97703 | 2019-01-09 |
| 1346743267 | Jesse Maggie Mae Abraham | Massage Therapist | 39 Nw Lousiana Ave, Bend, OR 97703 | 2018-03-16 |
| 1891202396 | Jerod Paul Michael | Speech-Language Pathologist | 2736 Nw Crossing Dr, Ste. 120, Bend, OR 97703 | 2018-01-05 |
| 1952823023 | Dan Packman | Massage Therapist | 2955 N. Hwy 97, Ste 105, Riverside Wellness, Voila Massage, Bend, OR 97703 | 2017-07-11 |
| 1023460102 | Brennon Patrick Moore | Counselor | 835 Nw Bond St Ste 100, Bend, OR 97703 | 2016-07-12 |
| 1093160269 | Eric Hinds | Optometrist | 63455 N Highway 97 Ste 75, Bend, OR 97703 | 2016-04-25 |
| 1417316191 | Ronald Guiley Od, Mph, PC | Clinic/Center | 63455 N Hwy 97, Ste 75, Bend, OR 97703 | 2016-02-23 |
| Find all providers in zip 97703 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093160269 | Eric Hinds | Optometrist | 63455 N Highway 97 Ste 75, Bend, OR 97703 | 2016-04-25 |
| 1912389511 | Central Oregon Eyecare, PC | Optometrist | 2155 Nw Shevlin Park Rd, Bend, OR 97701 | 2015-06-19 |
| 1447421292 | William R Woodman O.d. PC | Optometrist | 1900 Ne 3rd Street, Ste 102, Bend, OR 97701-3854 | 2008-03-20 |
| 1831397306 | Derri Sandberg | Optometrist | 901 Nw Carlon Ave Ste 2, Bend, OR 97703-2636 | 2007-07-06 |
| 1063623221 | Joseph J Kvortek | Optometrist | 3044 N Highway 97, Bend, OR 97701-7512 | 2007-05-26 |
| 1598970881 | Nancy Mckrell Bonetto | Optometrist | 19547 Sunshine Way, Bend, OR 97702-1980 | 2007-05-11 |
| 1972655264 | Tom Ski Thomason | Optometrist | 505 Sw Millview Way, # 100, Bend, OR 97702-1291 | 2007-01-17 |
| 1619024916 | William R Woodman | Optometrist | 1900 Ne 3rd St Ste 102, Bend, OR 97701-3854 | 2007-01-05 |
| 1811064967 | Coffman Vision Clinic Inc | Optometrist | 61535 S Highway 97, Ste. 16, Bend, OR 97702-2154 | 2006-11-30 |
| 1285700526 | Lorraine Mary Winger | Optometrist | 822 Nw Wall St, Bend, OR 97701-2715 | 2006-11-28 |
| Find all providers in BEND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.