B MICHAEL SOUTHAM O D PC (NPI# 1235412784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235412784 |
| Entity Type | Organization |
| Organization Name | B MICHAEL SOUTHAM O D PC |
| Other Organization Name | B. MICHAEL SOUTHAM, O.D., PC/ FAMILY VISION CARE OF CENTRAL WASHINGTON |
| Practice Address |
123 Hospital Way Brewster WA 98812-0578 |
| Practice Telephone | 5096892342 |
| Mailing Telephone | 5096892342 |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2012-08-06 |
| Authorized Official Name | DR. BRANT MICHAEL SOUTHAM (OPTOMETRIST/OWNER) |
| Authorized Official Telephone | 5096892342 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 60235215 | WA | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| B. Michael Southam, O.D., PC/ Family Vision Care of Central Washington | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922383207 | B Michael Southam O D PC | Optometrist | 407 Burdin Blvd, Grand Coulee, WA 99133-0054 | 2011-10-18 |
| Street Address |
123 HOSPITAL WAY |
| City | BREWSTER |
| State | WA |
| Zip Code | 98812-0578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528131398 | Dr Duane L Rana P S | Optometrist | 123 Hospital Way, Brewster, WA 98812-0578 | 2006-11-17 |
| 1124494620 | Gillespie Eye Care PC | Clinic/Center | 123 Hospital Way, Brewster, WA 98812-0015 | 2015-08-19 |
| 1477991263 | Kyle M. Gillespie, O.d., Ltd. | Optometrist | 123 Hospital Way, Brewster, WA 98812-0015 | 2013-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689032542 | Edith A Mcclosky | Massage Therapist | 718 West Main Avenue, Brewster, WA 98812 | 2016-02-08 |
| 1912327321 | Advantage Durable Medical Equipment, Inc | Durable Medical Equipment & Medical Supplies | 537 Main Ave, Brewster, WA 98812 | 2014-04-24 |
| 1639441165 | Central Washington Sleep Diagnostic Center, Pllc | Clinic/Center | 520 W Indian Avenue, Brewster, WA 98812 | 2012-01-30 |
| 1194019612 | Mitzi Gutierrez | Student in an Organized Health Care Education/Training Program | 343 E. Main Ave., Brewster, WA 98812 | 2011-06-01 |
| 1982938924 | Jason R Tucker | Dentist | 101 North 6th Street, Brewster, WA 98812 | 2009-09-23 |
| 1649409186 | Family Health Centers | Clinic/Center | 101 North Sixth Street, Brewster, WA 98812 | 2009-07-06 |
| 1972769446 | Bethany Lynn | Family Medicine | 418 W Main Street, Brewster, WA 98812 | 2008-08-04 |
| 1629237482 | Family Health Centers | Clinic/Center | 525 W Jay, Brewster, WA 98812 | 2008-06-06 |
| 1316138720 | L. Keith Hanson Pllc | Clinic/Center | 520 W. Indian Avenue, Brewster, WA 98812 | 2007-08-09 |
| 1639375124 | Robert Thomas Lamberton | Orthopaedic Surgery | 520 West Indian Avenue, Brewster, WA 98812 | 2007-06-22 |
| Find all providers in zip 98812 | ||||
| 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 |
|---|---|---|---|---|
| 1013442029 | Caremount Medical, PC | Optometrist | 2 International Blvd, Brewster, NY 10509 | 2017-04-27 |
| 1528131398 | Dr Duane L Rana P S | Optometrist | 123 Hospital Way, Brewster, WA 98812-0578 | 2006-11-17 |
| 1790144772 | Kaveri Vision and Wellness | Optometrist | 20 Milltown Rd, Suite 201, Brewster, NY 10509-4344 | 2016-02-18 |
| 1174994826 | Northern Medical Group, Pllc | Optometrist | 111 Clock Tower Cmns, Brewster, NY 10509-4055 | 2015-10-07 |
| 1477991263 | Kyle M. Gillespie, O.d., Ltd. | Optometrist | 123 Hospital Way, Brewster, WA 98812-0015 | 2013-06-13 |
| 1033387626 | Ross Opticians Co., Inc. | Optometrist | 20 Milltown Rd, Brewster, NY 10509-4344 | 2008-02-15 |
| 1467666982 | James J. Carroll | Optometrist | 111 Independent Way, Suite B, Brewster, NY 10509-2369 | 2007-05-10 |
| 1821172693 | Jay Suresh Desai | Optometrist | 20 Milltown Rd, Brewster, NY 10509-4344 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544101 | Destiny Nicole Mccoy | Optometrist | 19400 108th Ave Se Ste 202, Kent, WA 98031-0108 | 2020-09-25 |
| 1598370371 | Optometry Medical Group Inc | Optometrist | 1721 22nd Ave, Seattle, WA 98122-3324 | 2020-09-09 |
| 1962011320 | Kristine Marie Hackett | Optometrist | 19301 Se 34th St Ste 104, Camas, WA 98607-8881 | 2020-07-30 |
| 1245857044 | Minha Lee | Optometrist | 1468 158th Pl Ne, Bellevue, WA 98008-2782 | 2020-06-29 |
| 1437774734 | Vision Plus of Barkley Pllc | Optometrist | 2900 Woburn St Ste 101, Bellingham, WA 98226-3865 | 2020-06-11 |
| 1558985671 | Tiffany Lundberg | Optometrist | 2010 W Lincoln Ave Ste 1, Yakima, WA 98902-2413 | 2020-06-04 |
| 1801423041 | Jayeon Vision | Optometrist | 13909 Meridian E Ste A3, Puyallup, WA 98373-9180 | 2020-03-26 |
| 1124653464 | James Phelan | Optometrist | 14 N. Vernon Ave., Deer Park, WA 99006 | 2020-03-06 |
| 1942832845 | Trinity Vision Pllc | Optometrist | 4750 N Division St Ste 282, Spokane, WA 99207-1433 | 2020-02-07 |
| 1104464536 | Washington Eyes, LLC | Optometrist | 5011 W Lowell Ave Ste 120, Spokane, WA 99208-8587 | 2019-12-17 |
| Find all providers with the same taxonomy | ||||
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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.