Red Wing Optometric Clinic, P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2513 Issued in MN

Legal business name

RED WING OPTOMETRIC CLINIC, P.A.

Practice address

164 Tyler Rd S
Red Wing, MN 55066-1733

Phone

(651) 388-9187

NPI assigned

Jun 28, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chris J Palmer, OD

Title

Vice President

Phone

(651) 388-9187

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• eye care associates Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003813635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 TYLER RD S",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550661733",
            "telephone_number": "651-388-9187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 TYLER RD S",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550661733",
            "telephone_number": "651-388-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED WING OPTOMETRIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "651-388-9187",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "11707",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2200260",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMEPOS",
            "identifier": "0149240001",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1007983",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4C831PA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE PLUS EYEWEAR",
            "identifier": "5C066RE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE PLUS EXAMS",
            "identifier": "64216RE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "eye care associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Red Wing Health Center
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• Red Wing Health Center LLC
• Red Wing Health Center, LLC
• Red Wing Healthcare LLC
• Red Wing Public Schools
• Red Wing Vision Care LLC
• Sarah Reichert, MS, LICSW
• Stormie Ann Reiman
• Kim Ann Reinitz, RN, MSN, APRN, FNP-C

• Optometrist in Red Wing, MN
• Providers in Red Wing, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.