James a. Woodmansee. OD, PC – Optometrist

Key facts

NPI: 1154590727
Entity type: Organization (NPI type 2)
Primary specialty: Optometrist 152W00000X
License: 557 (ND)
Legal business name: JAMES A. WOODMANSEE. OD, PC
Practice address: 2551 32ND Ave S
James a. Woodmansee OD PC
Grand Forks, ND 58201-3607
Phone: (701) 780-8726
Fax: (701) 780-1284
NPI assigned: Feb 27, 2008
Organization subpart: No

Authorized official

Name: Dr. James A. Woodmansee, O.D. NPI 1912008335
Title: Owner
Phone: (701) 780-8726

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

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

James A. Woodmansee, O.D. Optometrist · Grand Forks, ND · NPI 1912008335

Medicare reassignment NPD Authorized official ND · OPTOMETRIST
Erica L Wiegandt, O.D. Optometrist · Grand Forks, ND · NPI 1013260850

Medicare reassignment NPD ND · OPTOMETRIST
Blake Kvidt, OD Optometrist · Litchfield, MN · NPI 1740779388

Medicare reassignment NPD ND · OPTOMETRIST

Medicare participation

Medicare fee-for-service enrollment: Enrolled in ND

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20050624000236	ND	Part B Supplier - Clinic/Group Practice	5991740441	Receives reassigned benefits from 3 practitioners Practice locations: Grand Forks, ND

National Provider Directory

Locations

2551 32nd Ave S
Ste A
Grand Forks, ND 58201
Phone (701) 780-8726

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist Group: 193400000X SINGLE SPECIALTY GROUP	152W00000X	557	ND	Yes

Addresses

Primary practice location

2551 32ND Ave S
James a. Woodmansee OD PC
Grand Forks, ND 58201-3607

Mailing address

2551 32ND Ave S
James a. Woodmansee OD PC
Grand Forks, ND 58201-3607
Phone (701) 780-8726

Other identifiers

Identifier	Type	State	Issuer
60499	Medicaid	ND

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 28, 2008.

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1154590727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 32ND AVE S",
            "address_2": "JAMES A. WOODMANSEE OD PC",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013607",
            "telephone_number": "701-780-8726",
            "fax_number": "701-780-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 32ND AVE S",
            "address_2": "JAMES A. WOODMANSEE OD PC",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013607",
            "telephone_number": "701-780-8726",
            "fax_number": "701-780-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES A. WOODMANSEE. OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "WOODMANSEE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-780-8726",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ND",
            "license": "557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60499",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

All providers in Grand Forks, ND · Optometrist in North Dakota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.