Organization Active NPI

Dr. Jaime L Haaland, Optometrist, P.C.

  • Optometrist
  • Minot, ND
National Provider Identifier
1023154390
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
623 Issued in ND
Legal business name
DR. JAIME L HAALAND, OPTOMETRIST, P.C.
Practice address
10 1St St SW
Minot, ND 58701-3859
Phone
(701) 839-5000
Fax
(701) 852-4072
NPI assigned
Jan 30, 2007
Last updated
Dec 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Authorized official

Name
Dr. Jaime Lynn Haaland, O.D.NPI 1275513152
Title
Owner
Phone
(701) 839-5000

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
Optometrist 152W00000X 623 ND Primary

Addresses

Primary practice location

10 1St St SW
Minot, ND 58701-3859

Mailing address

10 1St St SW
Minot, ND 58701-3859
Phone (701) 839-5000

Other identifiers 2

IdentifierTypeStateIssuer
60606MedicaidND
1275513152OtherNPI FOR INDIVIDUAL O.D.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050208000121 ND Part B Supplier - Clinic/Group Practice 4183675176 Receives reassigned benefits from 1 practitioner
Practice locations: Minot, ND
O20100930076981 ND DME Supplier - Physician - Optometrist 4183675176 Practice locations: Minot, ND

National Provider Directory

National Provider Directory

Locations

932 37th Ave SW
Minot, ND 58701
Phone (701) 839-5000

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": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1023154390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 1ST ST SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013859",
            "telephone_number": "701-839-5000",
            "fax_number": "701-852-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 1ST ST SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013859",
            "telephone_number": "701-839-5000",
            "fax_number": "701-852-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JAIME L HAALAND, OPTOMETRIST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "HAALAND",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-839-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60606",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR INDIVIDUAL O.D.",
            "identifier": "1275513152",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; 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.