Hawkeye Exact SD 1 PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

HAWKEYE EXACT SD 1 PLLC

Practice address

11 Shriner St
Vermillion, SD 57069-1155

Phone

(605) 624-2020

NPI assigned

May 22, 2024

Organization subpart

No

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

Authorized official

Name

Thomas Wiertzema

Title

Coo

Phone

(605) 940-6200

Specialties & licenses 1

Addresses

Other names 2

• Prairie Eye Clinic Doing business as
• Brown Optometric Clinic, PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victoria Jo Johnson, OD

  • Optometrist
  • Vermillion, SD
  • NPI 1346928751
  Medicare reassignment Care Compare group NPD
• Travis Adam Larson, OD

  • Optometrist
  • Vermillion, SD
  • NPI 1538053277
  Medicare reassignment Care Compare group NPD
• Clarence Joseph Vanderlei, O.D.

  • Optometrist
  • Rock Valley, IA
  • NPI 1811347685

  SD

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1013756899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SHRINER ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570691155",
            "telephone_number": "605-624-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SHRINER ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570691155",
            "telephone_number": "605-624-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWKEYE EXACT SD 1 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "WIERTZEMA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "605-940-6200"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brown Optometric Clinic, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Brown Optometric Clinic, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Carrie Lyn Hanson, DPT
• Elizabeth Kay Hanson, PH.D., CCC-SLP
• Amy L. Haselhorst, COTA/L
• Heidi Hassler, PA-C
• Patrick L Hauer, PT
• Lois Jean Hazen, MT
• Steven J. Heirigs, R.PH.
• Kate Herrboldt, ATC
• Michelle Merrigan Hinseth, CSWPIP
• Chabli Hodge, LCSW

• Optometrist in Vermillion, SD
• Providers in Vermillion, SD by specialty
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.