OPTIC ART III, PLLC (NPI# 1851663512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851663512 |
| Entity Type | Organization |
| Organization Name | OPTIC ART III, PLLC |
| Practice Address |
213 N Main St Moscow ID 83843-2700 |
| Practice Telephone | 2088822932 |
| Mailing Telephone | 2088822932 |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-01-27 |
| Authorized Official Name | DR. RODGER DEAN ROBERTSON (OPTOMETRIC PHYSICIAN) |
| Authorized Official Telephone | 2088822932 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | ODP-552 | ID | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 805042600 | 05 |
| Street Address |
213 N MAIN ST |
| City | MOSCOW |
| State | ID |
| Zip Code | 83843-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952942195 | Jessica Alexandra Cruz | Physician Assistant | 213 N Main St, Moscow, ID 83843-2700 | 2019-09-30 |
| 1205317856 | Sara B Presol | Nurse Practitioner | 213 N Main St, Moscow, ID 83843-2700 | 2018-08-22 |
| 1376857862 | Providence Health & Services | Internal Medicine | 213 N Main St, Moscow, ID 83843-2700 | 2010-07-27 |
| 1093946097 | Optic Art II, P.C. | Optometrist | 213 N Main St, Moscow, ID 83843-2700 | 2009-08-07 |
| 1255510442 | Deborah Wynne Medel | Nurse Practitioner | 213 N Main St, Moscow, ID 83843-2700 | 2007-10-24 |
| 1487869798 | Inclusion North, Inc. | Day Training, Developmentally Disabled Services | 213 N Main St, Suite #1, Moscow, ID 83843-2700 | 2007-05-11 |
| 1407069438 | Inclusion North, Inc | Nursing Care | 213 N Main St, Suite #1, Moscow, ID 83843-2700 | 2007-05-07 |
| 1871646976 | Moscow Medical, P.a. | Family Medicine | 213 N Main St, Moscow, ID 83843-2700 | 2007-01-19 |
| 1265503320 | Rodger Dean Robertson | Optometrist | 213 N Main St, Moscow, ID 83843-2700 | 2006-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
| 1770141384 | Lingwen Zhang | Specialist/Technologist | 901 Paradise Creek Rd, Moscow, ID 83843 | 2019-05-30 |
| 1306363478 | Elizabeth Campbell | Dietitian, Registered | 611 S. Main, Moscow, ID 83843 | 2017-08-29 |
| 1598285496 | Gina Cretser | Counselor | 212 Rodeo Dr. #410, Moscow, ID 83843 | 2017-06-21 |
| 1124558721 | Morgan Leigh Derloshon | Specialist/Technologist | 275 Southview Ave, Apt 206, Moscow, ID 83843 | 2017-06-15 |
| 1619411790 | Kaylene Howard | Massage Therapist | 127 South Washington, Suite 6, Moscow, ID 83843 | 2016-12-08 |
| 1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
| 1366851388 | Elisabeth Henry | Pharmacist | 2740 West Pullman Rd, Moscow, ID 83843 | 2014-08-04 |
| Find all providers in zip 83843 | ||||
| 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 |
|---|---|---|---|---|
| 1285170696 | Wilson Polito Inc | Optometrist | 1844 W Pullman Rd, Moscow, ID 83843-4014 | 2017-01-09 |
| 1457793507 | Enjoli Oleeta Cooke | Optometrist | 212 Rodeo Dr Ste 410, Moscow, ID 83843 | 2013-07-17 |
| 1124373410 | Stacie Zollman | Optometrist | 872 Troy Rd Ste 130, Moscow, ID 83843-5035 | 2012-07-23 |
| 1598794737 | George A Paris | Optometrist | 1205 E 6th St, Moscow, ID 83843-3705 | 2006-07-01 |
| 1215912472 | Randall Perry Cummings | Optometrist | 1420 S Blaine St Ste 6, Moscow, ID 83843-3973 | 2005-12-09 |
| 1891782215 | Richard Eugene Margerum | Optometrist | 326 N Main St, Moscow, PA 18444-9155 | 2005-09-30 |
| 1841298213 | William R French | Optometrist | 202 E 7th St, Moscow, ID 83843-3002 | 2005-07-11 |
| 1689136178 | Inland Eye Care Pllc | Optometrist | 212 Rodeo Dr Ste 410, Moscow, ID 83843-9794 | 2019-04-03 |
| 1154673499 | Nevada Rae Sweeney | Optometrist | 1205 E 6th St, Moscow, ID 83843 | 2012-10-10 |
| 1093946097 | Optic Art II, P.C. | Optometrist | 213 N Main St, Moscow, ID 83843-2700 | 2009-08-07 |
| Find all providers in MOSCOW | ||||
Please comment or provide details below to improve the information on OPTIC ART III, PLLC.
| 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.