Organization Active NPI

Hawkeye Clinic of Luverne, PC

Doing business as Rock County Eye Clinic

  • Optometrist
  • Luverne, MN
National Provider Identifier
1265580898
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HAWKEYE CLINIC OF LUVERNE, PC
Doing business as
Rock County Eye Clinic
Practice address
104 N Freeman Ave
Luverne, MN 56156-1628
Phone
(507) 283-2345
Fax
(507) 283-2346
NPI assigned
Jan 8, 2007
Last updated
Nov 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Chris K Loosbrock
Title
Insurance Coordinator
Phone
(507) 283-2345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

104 N Freeman Ave
Luverne, MN 56156-1628

Mailing address

102 N Freeman Ave
Luverne, MN 56156-1628
Phone (507) 283-2345

Other identifiers 1

IdentifierTypeStateIssuer
519524100MedicaidMN

Other names 1

  • Rock County Eye Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061102000487 MN Part B Supplier - Clinic/Group Practice 0547267635 Receives reassigned benefits from 1 practitioner
Practice locations: Luverne, MN

National Provider Directory

National Provider Directory

Locations

102 N Freeman Ave
Luverne, MN 56156
Phone (507) 283-2345

104 N Freeman Ave
Luverne, MN 56156
Phone (507) 283-2345

Practitioners & affiliated clinicians

Practitioners 4

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1265580898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N FREEMAN AVE",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561561628",
            "telephone_number": "507-283-2345",
            "fax_number": "507-283-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N FREEMAN AVE",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561561628",
            "telephone_number": "507-283-2345",
            "fax_number": "507-283-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWKEYE CLINIC OF LUVERNE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "LOOSBROCK",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "507-283-2345"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "519524100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rock County Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rock County Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Luverne, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.