PBR Optometrists LTD of Springfield

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PBR OPTOMETRISTS LTD OF SPRINGFIELD

Practice address

602 North Jackson Ave
Springfield, MN 56087-0186

Phone

(507) 723-5115

Fax

(507) 723-6480

NPI assigned

Jan 23, 2007

Last updated

Apr 18, 2008By 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. Steven J Peterson, OD

Title

Direct Owner

Phone

(507) 629-3230

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1083769095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 NORTH JACKSON AVE",
            "address_2": "PO BOX 186",
            "city": "SPRINGFIELD",
            "state": "MN",
            "postal_code": "560870186",
            "telephone_number": "507-723-5115",
            "fax_number": "507-723-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 NORTH JACKSON AVE",
            "city": "SPRINGFIELD",
            "state": "MN",
            "postal_code": "560870186",
            "telephone_number": "507-723-5115",
            "fax_number": "507-723-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBR OPTOMETRISTS LTD OF SPRINGFIELD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "507-629-3230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "3C276PB",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "112984",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE PLUS",
            "identifier": "3C276PB",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "43233PB",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "898861020124",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua J Hoffmann
• Ind School Dist 85
• Alice A Johnson, PT
• Mayo Clinic Health System-Southwest Minnesota Region (Mayo Clinic Health System-Springfield)
• Sharon Lynn Meyer, OTR/L
• Eden Polito, APRN, FNP-C
• Daren Randall, ARNP
• Betsy Saffert, MT
• Ronda Kay Sawatzky, P.T.
• Ashley Marie Schmitt

• Optometrist in Springfield, MN
• Providers in Springfield, MN by specialty
• Optometrist in Minnesota

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