Individual provider Active NPI

Jonathan James Schorn, O.D.

  • Optometrist
  • Lakeville, MN
National Provider Identifier
1063484566
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MN2750 Issued in MN
Practice address
16105 Cedar Ave
Lakeville, MN 55044-7213
Phone
(952) 985-6467
Fax
(952) 985-6468
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MN2750 MN Primary

Addresses

Primary practice location

16105 Cedar Ave
Lakeville, MN 55044-7213

Mailing address

16105 Cedar Ave
Lakeville, MN 55044-7213
Phone (952) 985-6467

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
MN2750MNMDOptometrist
2750MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Eyecare Associates Past Accepting new patients
Proeyecare Associates PA Past Accepting new patients
Foley Eye Clinic PA PastSince Jul 15, 2017 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1063484566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16105 CEDAR AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447213",
            "telephone_number": "952-985-6467",
            "fax_number": "952-985-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16105 CEDAR AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447213",
            "telephone_number": "952-985-6467",
            "fax_number": "952-985-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHORN",
        "first_name": "JONATHAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN2750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.