Organization Active NPI

Black Hills Optical LLP

Doing business as Black Hills Vision Care

  • Durable Medical Equipment & Medical Supplies
  • Belle Fourche, SD
National Provider Identifier
1043435746
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BLACK HILLS OPTICAL LLP
Doing business as
Black Hills Vision Care
Practice address
1830 5TH Ave
Belle Fourche, SD 57717
Phone
(605) 892-4411
NPI assigned
Apr 16, 2007
Last updated
Oct 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Authorized official

Name
December White
Title
Optician
Phone
(605) 892-4411

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

1830 5TH Ave
Belle Fourche, SD 57717

Mailing address

1830 5TH Ave
Belle Fourche, SD 57717
Phone (605) 892-4411

Other identifiers 1

IdentifierTypeStateIssuer
9280613MedicaidSD

Other names 1

  • Black Hills Vision Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930054830 SD DME Supplier - Optician 6608997424 Practice locations: Belle Fourche, 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
Black Hills Optical1830 5TH Ave, Belle Fourche, SD 57717-208960589244111 Prosthetic Lenses: Conventional Eyeglasses Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

1830 5th Ave
Belle Fourche, SD 57717
Phone (605) 892-2020

Practitioners & affiliated clinicians

Practitioners 1

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446076800000",
    "number": "1043435746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 5TH AVE",
            "city": "BELLE FOURCHE",
            "state": "SD",
            "postal_code": "57717",
            "telephone_number": "605-892-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 5TH AVE",
            "city": "BELLE FOURCHE",
            "state": "SD",
            "postal_code": "57717",
            "telephone_number": "605-892-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK HILLS OPTICAL LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2015-10-29",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DECEMBER",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "605-892-4411"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9280613",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Black Hills Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belle Fourche, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.