Organization Active NPI

Krall Optometric Prof LLC

Doing business as Krall Eye Clinic

  • Optometrist
  • Mitchell, SD
National Provider Identifier
1013049410
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KRALL OPTOMETRIC PROF LLC
Doing business as
Krall Eye Clinic
Practice address
1415 N Sanborn Blvd
Mitchell, SD 57301-1015
Phone
(605) 996-2020
NPI assigned
Mar 12, 2007
Last updated
Jul 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Authorized official

Name
Dr. Joe Krall, O.D.NPI 1811043102
Title
Optometrist
Phone
(605) 996-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1415 N Sanborn Blvd
Mitchell, SD 57301-1015

Mailing address

1415 N Sanborn Blvd
Mitchell, SD 57301-1015

Other names 1

  • Krall Eye Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080414000171 SD Part B Supplier - Clinic/Group Practice 4284711391 Receives reassigned benefits from 4 practitioners
Practice locations: Armour, SD; Mitchell, SD
O20100930006938 SD DME Supplier - Physician - Optometrist 4284711391 Practice locations: Mitchell, SD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Krall Optometric Prof LLC1415 N Sanborn Blvd, Mitchell, SD 57301-1015(605) 996-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Does not accept assignmentParticipating since Jan 1, 1996

National Provider Directory

National Provider Directory

Locations

1415 N Sanborn Blvd
#777
Mitchell, SD 57301
Phone (605) 996-2020

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373587200000",
    "number": "1013049410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 N SANBORN BLVD",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N SANBORN BLVD",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011015",
            "telephone_number": "605-996-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRALL OPTOMETRIC PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2013-07-12",
        "status": "A",
        "authorized_official_last_name": "KRALL",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "605-996-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Krall Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mitchell, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.