Douglas Roland Landsverk, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1998 Issued in MN

Practice address

312 Minnesota Ave N
Aitkin, MN 56431-1414

Phone

(218) 927-3213

Fax

(218) 927-2266

NPI assigned

May 12, 2006

Last updated

Mar 3, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eyecare Centers of Aitkin & McGregor Optometrists, PA

  • Optometrist
  • Aitkin, MN
  • NPI 1104855287
  NPD

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1265483606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 MINNESOTA AVE N",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "564311414",
            "telephone_number": "218-927-3213",
            "fax_number": "218-927-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 MINNESOTA AVE N",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "564311414",
            "telephone_number": "218-927-3213",
            "fax_number": "218-927-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDSVERK",
        "first_name": "DOUGLAS",
        "middle_name": "ROLAND",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2210683",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5C924LA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097723300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Paul Kujawa, R.PH.
• Lisa Marie Kuklis, R.D.
• Amanda Kurtz
• Emily Elizabeth Kyllonen, MSED, LPCC
• Diane P Landstad, N.P.
• Janet A Larson, PSYNP, PHD, FNP
• Thomas J Lawson, MD
• Elizabeth Lilley
• Wendy Joan Mack, OTR/L
• Joel Adam Madson, MD

• Optometrist in Aitkin, MN
• Providers in Aitkin, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.