Oakdale Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1460 Issued in MN

Legal business name

OAKDALE OPTICAL

Practice address

7013 10TH St N
Oakdale, MN 55128-5938

Phone

(651) 738-8040

Fax

(651) 714-0759

NPI assigned

Jan 19, 2007

Organization subpart

No

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

Authorized official

Name

John M Elverum, ODNPI 1053463554

Title

Owner

Phone

(651) 738-8040

Specialties & licenses 1

Addresses

Other identifiers 8

Practitioners 2

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

• John M Elverum, OD

  • Optometrist
  • Oakdale, MN
  • NPI 1053463554
  NPD (past) Authorized official
• Trent D Cole, OD

  • Optometrist
  • Oakdale, MN
  • NPI 1700847035
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235282633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7013 10TH ST N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285938",
            "telephone_number": "651-738-8040",
            "fax_number": "651-714-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7013 10TH ST N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285938",
            "telephone_number": "651-738-8040",
            "fax_number": "651-714-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKDALE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELVERUM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-738-8040",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": "1460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SITE",
            "identifier": "56097EL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "86629EL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "101869",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE HARDWARE",
            "identifier": "106141",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DISP",
            "identifier": "1C741OA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2222625",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA DISP",
            "identifier": "2113780",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE GROUP",
            "identifier": "106141",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer R O'Connor, LMFT
• Stacy O'Malley
• Oak Springs Chiropractic & Wellness
• Oakdale Care Community, LLC
• Oakdale Family Dentistry, Inc.
• Oakwinds Clinic of Chiropractic, P.a.
• Oakwood Chiropractic Clinic, Inc.
• Brittany Ogaard, DPT
• Ngozi Miriam Ohaegbulem, NP
• Joshua Charles Ohara

• Eyewear Supplier in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.