NPIMap

Organization Active NPI

Durand Optometry Clinic LLC Dba Mondovi Eye and Optical

  • Optometrist
  • Mondovi, WI
National Provider Identifier
1215066212
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2689 Issued in WI
Legal business name
DURAND OPTOMETRY CLINIC LLC DBA MONDOVI EYE AND OPTICAL
Practice address
129 S. Eau Claire St.
Mondovi, WI 54755-0087
Phone
(715) 926-4273
NPI assigned
Mar 5, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Tony Raymond Morris, O.D.NPI 1588639371
Title
Owner
Phone
(715) 926-4273

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 2689 WI Primary

Addresses

Primary practice location

129 S. Eau Claire St.
Mondovi, WI 54755-0087

Mailing address

PO Box 87
Mondovi, WI 54755-0087
Phone (715) 926-4273

Other identifiers 6

IdentifierTypeStateIssuer
5681910002OtherWIDMERC
2100792OtherMEDICA- MATERIALS
439K2MOOtherMNBCBS OF MN
45861OtherSPECTERA
2216527OtherMEDICA -EXAM
38725600MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Durand Optometry Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1215066212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547550087",
            "telephone_number": "715-926-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 S. EAU CLAIRE ST.",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547550087",
            "telephone_number": "715-926-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURAND OPTOMETRY CLINIC LLC DBA MONDOVI EYE AND OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-926-4273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5681910002",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA- MATERIALS",
            "identifier": "2100792",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "439K2MO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "45861",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA -EXAM",
            "identifier": "2216527",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38725600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mondovi, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.