NPIMap

Organization Active NPI

Optical Shop of Kalispell

  • Eyewear Supplier
  • Kalispell, MT
National Provider Identifier
1053564658
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
C187758-906105 Issued in MT
Legal business name
OPTICAL SHOP OF KALISPELL
Practice address
35 Main St Ste B
Kalispell, MT 59901-4448
Phone
(406) 755-9001
NPI assigned
Oct 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Mr. Michael S Matola
Title
Owner
Phone
(406) 755-9001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X C187758-906105 MT Primary

Addresses

Primary practice location

35 Main St Ste B
Kalispell, MT 59901-4448

Mailing address

35 Main St Ste B
Kalispell, MT 59901-4448
Phone (406) 755-9001

National Provider Directory

National Provider Directory

Locations

35 Main St
Ste B
Kalispell, MT 59901
Phone (406) 755-9001

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1053564658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MAIN ST STE B",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014448",
            "telephone_number": "406-755-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MAIN ST STE B",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014448",
            "telephone_number": "406-755-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL SHOP OF KALISPELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "MATOLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-755-9001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MT",
            "license": "C187758-906105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.