Organization Active NPI

Angela R. Gulbranson, OD, PC

  • Optometrist
  • Sioux Falls, SD
National Provider Identifier
1235309162
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SD565 Issued in SD
Legal business name
ANGELA R. GULBRANSON, OD, PC
Practice address
6201 S Minnesota Ave
Sioux Falls, SD 57108-2559
Phone
(605) 274-6717
Fax
(605) 275-4804
NPI assigned
Mar 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Authorized official

Name
Allison Pulford
Title
Office Manager
Phone
(605) 274-6717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X SD565 SD Primary

Addresses

Primary practice location

6201 S Minnesota Ave
Sioux Falls, SD 57108-2559

Mailing address

6201 S Minnesota Ave
Sioux Falls, SD 57108-2559
Phone (605) 274-6717

Other identifiers 1

IdentifierTypeStateIssuer
9203263MedicaidSD

Other names 1

  • Visions Eye Care & Therapy Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013001120 SD Part B Supplier - Clinic/Group Practice 9830159979 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Sioux Falls, SD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

106 W 69th St
Sioux Falls, SD 57108
Phone (605) 274-6717

6144 S Lyncrest Ave
Sioux Falls, SD 57108
Phone (605) 271-7100

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557446400000",
    "number": "1235309162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082559",
            "telephone_number": "605-274-6717",
            "fax_number": "605-275-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082559",
            "telephone_number": "605-274-6717",
            "fax_number": "605-275-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA R. GULBRANSON, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2019-05-10",
        "status": "A",
        "authorized_official_last_name": "PULFORD",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "605-274-6717"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SD",
            "license": "SD565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9203263",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visions Eye Care & Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.