Forest Lake Optometric Center

Primary specialty

OptometristTaxonomy code 152W00000X

License

2070000 Issued in MN

Legal business name

FOREST LAKE OPTOMETRIC CENTER

Doing business as

North Woods Optics

Practice address

20 Lake St N
Forest Lake, MN 55025-2523

Phone

(651) 464-4824

Fax

(651) 464-0003

NPI assigned

Dec 15, 2006

Last updated

Dec 1, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Lee Bahr, O.D.NPI 1558423731

Title

Dr

Phone

(651) 464-4824

Specialties & licenses 1

Addresses

Other names 1

• North Woods Optics Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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.

• Kevin Lee Bahr, O.D.

  • Optometrist
  • Forest Lake, MN
  • NPI 1558423731
  Medicare reassignment Care Compare group NPD Authorized official
• Richard David Bruesch, OD

  • Optometrist
  • Forest Lake, MN
  • NPI 1922119486
  Medicare reassignment Care Compare group NPD
• Scott R Telander, O.D.

  • Optometrist
  • Forest Lake, MN
  • NPI 1437254455
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1053473835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LAKE ST N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252523",
            "telephone_number": "651-464-4824",
            "fax_number": "651-464-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 LAKE ST N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252523",
            "telephone_number": "651-464-4824",
            "fax_number": "651-464-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST LAKE OPTOMETRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "BAHR",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "651-464-4824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2070000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Woods Optics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neh Buma Foncham, PSYCHIATRIC NP
• Forest Lake Area Schools #831
• Forest Lake Chiropractic Clinic, P.a.
• Forest Lake Endodontics
• Forest Lake Home Care Inc
• Forest Lake Orthodontics (Travis W. Wille, DDS, MS)
• Forest Lake Skin and Vein Clinic
• Forest Lake Smiles, PA
• Lisa Marie Forslund, CNP
• Harvey J Frank, MD

• Optometrist in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.