NPIMap

Organization Active NPI

Osgood Eyecare Professionals, LLC

  • Optometrist
  • Fargo, ND
National Provider Identifier
1184992364
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
685 Issued in ND
Legal business name
OSGOOD EYECARE PROFESSIONALS, LLC
Practice address
4622 40TH Ave S
Fargo, ND 58104-4394
Phone
(701) 364-2909
Fax
(701) 364-9346
NPI assigned
Dec 2, 2011
Last updated
Apr 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Authorized official

Name
Dr. Jonathan Larson, ODNPI 1912061458
Title
Owner
Phone
(320) 304-1027

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 685 ND Primary

Addresses

Primary practice location

4622 40TH Ave S
Fargo, ND 58104-4394

Mailing address

4622 40TH Ave S
Fargo, ND 58104-4394
Phone (701) 364-2909

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1184992364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4622 40TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044394",
            "telephone_number": "701-364-2909",
            "fax_number": "701-364-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 40TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044394",
            "telephone_number": "701-364-2909",
            "fax_number": "701-364-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSGOOD EYECARE PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-304-1027",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.