Organization Active NPI

Great Northern Eye Care and Stumptown Spectacles, PLLC

  • Optometrist
  • Whitefish, MT
National Provider Identifier
1235381401
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
639 Issued in MT
Legal business name
GREAT NORTHERN EYE CARE AND STUMPTOWN SPECTACLES, PLLC
Practice address
6414 US Highway 93 S
Whitefish, MT 59937-8237
Phone
(406) 862-6123
NPI assigned
Oct 19, 2008
Last updated
Aug 31, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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

Authorized official

Name
Eva Buker, O.D.NPI 1033262076
Title
Optometrist/Owner
Phone
(406) 253-0086

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 639 OPT MT
Optometrist 152W00000X 639 MT Primary

Addresses

Primary practice location

6414 US Highway 93 S
Whitefish, MT 59937-8237

Mailing address

6414 US Highway 93 S
Whitefish, MT 59937-8237
Phone (406) 862-6123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091021000505 MT Part B Supplier - Clinic/Group Practice 7113064379 Receives reassigned benefits from 1 practitioner
Practice locations: Whitefish, MT

National Provider Directory

National Provider Directory

Locations

6414 US Highway 93 S
Whitefish, MT 59937
Phone (406) 862-6123

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": "1224374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1235381401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6414 US HIGHWAY 93 S",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599378237",
            "telephone_number": "406-862-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6414 US HIGHWAY 93 S",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599378237",
            "telephone_number": "406-862-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT NORTHERN EYE CARE AND STUMPTOWN SPECTACLES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-19",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "BUKER",
        "authorized_official_first_name": "EVA",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "406-253-0086",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MT",
            "license": "639 OPT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitefish, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.