Individual provider Active NPI

Kari J Burgard, OD

  • Optometrist
  • St Anthony, MN
National Provider Identifier
1164713392
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3303 Issued in MN
Practice address
2929 Pentagon Dr
St Anthony, MN 55418-3208
Phone
(612) 781-4730
Fax
(612) 706-2337
NPI assigned
Apr 21, 2011
Last updated
Jul 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3303 MN Primary
Optometrist 152W00000X 698 ND

Addresses

Primary practice location

2929 Pentagon Dr
St Anthony, MN 55418-3208

Mailing address

2929 Pentagon Dr
St Anthony, MN 55418-3208
Phone (612) 781-4730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120824000622 ND Practitioner - Optometry 1254588387 Reassigns benefits to 1 organization
I20130731000372 MN Practitioner - Optometry 1254588387 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
698NDMDRegistered Dietitian
3303MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthony Optometric Clinic CurrentSince Jun 10, 2013 Accepting new patients
Eye Center of the Dakotas, PC Optometrist CurrentSince Oct 1, 2023 Accepting new patients

Locations

2929 Pentagon Dr
St Anthony, MN 55418
Phone (612) 781-4730

1221 W Divide Ave
Ste 1
Bismarck, ND 58501
Phone (701) 224-0661

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1164713392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 PENTAGON DR",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554183208",
            "telephone_number": "612-781-4730",
            "fax_number": "612-706-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 PENTAGON DR",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554183208",
            "telephone_number": "612-781-4730",
            "fax_number": "612-706-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGARD",
        "first_name": "KARI",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-21",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3303",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "698",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Anthony, MN

Sources for this page

Verify at the official NPI Registry.