Minnesota Vision Group PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MINNESOTA VISION GROUP PA

Doing business as

INSIGHT EYE CARE

Practice address

206 W Division St
Waite Park, MN 56387-1662

Phone

(320) 253-0365

Fax

(320) 253-9401

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Greg J Friederichs, OD

Title

Owner

Phone

(320) 253-0365

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• INSIGHT EYE CARE Doing business as

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1235151291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W DIVISION ST",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871331",
            "telephone_number": "320-253-0365",
            "fax_number": "320-253-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W DIVISION ST",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871662",
            "telephone_number": "320-253-0365",
            "fax_number": "320-253-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA VISION GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "FRIEDERICHS",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-253-0365",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161524600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2298740",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "54327CL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "2352",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INSIGHT EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Lynne Miller, PH.D., LP
• Owen Christopher Miller
• Rebecca Anne Miller, AGNP-C
• Andre Laroy Mills Jr.
• Minneapolis Senior Services
• Minnesota Vision Group PA
• Faviola Yaritza Miranda de Jesus
• MN Lakes Transportation, LLC
• Ashley Moen
• Abdikafi Mohamed

• Optometrist in Waite Park, MN
• Providers in Waite Park, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.