Individual provider Active NPI

Paul James Fleming, O.D.

  • Optometrist
  • Savage, MN
National Provider Identifier
1033472865
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3293 Issued in MN
Practice address
14734 Yosemite Ave S
Savage, MN 55378-4907
Phone
(952) 270-6130
NPI assigned
Jun 18, 2012
Last updated
Jun 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3293 MN Primary

Addresses

Primary practice location

14734 Yosemite Ave S
Savage, MN 55378-4907

Mailing address

14734 Yosemite Ave S
Savage, MN 55378-4907
Phone (952) 270-6130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3293MNMDMarriage & Family Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1033472865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14734 YOSEMITE AVE S",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784907",
            "telephone_number": "952-270-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14734 YOSEMITE AVE S",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784907",
            "telephone_number": "952-270-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "PAUL",
        "middle_name": "JAMES",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savage, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.