PEND OREILLE VISION CARE (NPI# 1861938250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861938250 |
| Entity Type | Organization |
| Organization Name | PEND OREILLE VISION CARE |
| Other Organization Name | BONNERS FERRY EYE CARE |
| Practice Address |
6348 Main St Bonners Ferry ID 83805 |
| Mailing Address |
514 Oak St Ste A Sandpoint ID 83864-1480 |
| Practice Telephone | 2082671087 |
| Practice Fax Number | 2082672235 |
| Mailing Telephone | 2082657965 |
| Mailing Fax Number | 2082657905 |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2018-05-17 |
| Authorized Official Name | DR. NATHANEAL HARRELL (PRESIDENT) |
| Authorized Official Telephone | 2082657965 |
| Authorized Official Credential | OD |
| Is Organization Subpart | Y |
| Parent Organization Name | PEND OREILLE VISION CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | ID | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bonners Ferry Eye Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104316785 | Pend Oreille Vision Care | Clinic/Center | 6132 Highway 2, Priest River, ID 83856 | 2018-05-18 |
| 1871849059 | Pend Oreille Vision Care | Clinic/Center | 514 Oak St Ste A, Sandpoint, ID 83864-1480 | 2012-07-25 |
| Street Address |
6348 MAIN ST |
| City | BONNERS FERRY |
| State | ID |
| Zip Code | 83805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871878926 | Danielle E. Tholl | Optometrist | 6348 Main St, Bonners Ferry, ID 83805-8519 | 2011-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366990996 | Nicole Diana Madill | Counselor | 687 Cody Street, Bonners Ferry, ID 83805 | 2016-09-12 |
| 1154770295 | Rachel Meiland Webster | Social Worker | 6686 Augusta Bldg 100, Bonners Ferry, ID 83805 | 2016-06-09 |
| 1205211786 | Robert Rossi | Social Worker | Kaniksu Health Services, 6615 Comanche St, Bonners Ferry, ID 83805 | 2015-07-24 |
| 1154660041 | Mark R. Barker, O.d.p.c. | Optometrist | 7177 Main St., Bonners Ferry, ID 83805 | 2013-02-12 |
| 1003182668 | Jessica Faye Horricks | Dentist | 6615 Commanche, Bonners Ferry, ID 83805 | 2012-03-28 |
| 1427334929 | Tanya Marie Allmaras | Physician Assistant | 6635 Comanche Street, Bonners Ferry, ID 83805 | 2011-10-27 |
| 1114259769 | Joshua Olen Shelton | Chiropractor | 6389 Bonner St., Bonners Ferry, ID 83805 | 2010-02-08 |
| 1558690644 | April C Christman | Social Worker | 6615 Comanche Street, Bonners Ferry, ID 83805 | 2009-12-18 |
| 1407006067 | Denys Taipale-knight | Counselor | 385 Moose Ridge Lane, Bonners Ferry, ID 83805 | 2008-09-19 |
| 1013126457 | John Pierce Brownlee Jr. | Registered Nurse | 6640 Kaniksu Street, Boundary Community Hospital, Bonners Ferry, ID 83805 | 2007-05-22 |
| Find all providers in zip 83805 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669594057 | Kootenai Tribe of Idaho | Clinic/Center | 100 Circle Drive, Bonners Ferry, ID 83805-1279 | 2007-04-04 |
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|---|---|---|---|---|
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| 1528623915 | D & S Works | Clinic/Center | 5622 W State St, Boise, ID 83703-3010 | 2019-05-01 |
| 1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
| 1912487646 | Ideal Option, Pllc | Clinic/Center | 509 W Hanley Ave Ste 101, Coeur D Alene, ID 83815-8994 | 2018-08-21 |
| 1801376256 | Ideal Option, Pllc | Clinic/Center | 1111 Blue Lakes Blvd N Ste E, Twin Falls, ID 83301-3437 | 2018-08-15 |
| 1649759374 | North Canyon Mountain Home Clinic | Clinic/Center | 840 N 4th E, Mountain Home, ID 83647-2166 | 2018-08-13 |
| Find all providers with the same taxonomy | ||||
| City | BONNERS FERRY |
| Zip Code | 83805 |
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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.