Organization Active NPI

Visionary Eye Care

  • Optometrist
  • Dickinson, ND
National Provider Identifier
1124200688
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISIONARY EYE CARE
Practice address
341 1St St E
Dickinson, ND 58601-5216
Phone
(701) 483-9141
Fax
(701) 483-9501
NPI assigned
Nov 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Authorized official

Name
Dr. Candace K Hoff, OD
Title
President
Phone
(701) 483-9141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X ND Primary

Addresses

Primary practice location

341 1St St E
Dickinson, ND 58601-5216

Mailing address

341 1St St E
Dickinson, ND 58601-5216
Phone (701) 483-9141

Other identifiers 4

IdentifierTypeStateIssuer
060580MedicaidND
01284002OtherNDBCBS
DA9711OtherNDRAILROAD MEDICARE
4694550001OtherNDNORIDIAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041012001119 ND Part B Supplier - Clinic/Group Practice 8325008683 Receives reassigned benefits from 3 practitioners
Practice locations: Dickinson, ND

National Provider Directory

National Provider Directory

Locations

341 1st St E
Dickinson, ND 58601
Phone (701) 483-9141

3177 15th St W
Dickinson, ND 58601
Phone (701) 483-9141

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1124200688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 1ST ST E",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586015216",
            "telephone_number": "701-483-9141",
            "fax_number": "701-483-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 1ST ST E",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586015216",
            "telephone_number": "701-483-9141",
            "fax_number": "701-483-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "HOFF",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-483-9141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060580",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01284002",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA9711",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORIDIAN",
            "identifier": "4694550001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.