Individual provider Active NPI

Whitney Page Lauer

  • Optometrist
  • Virginia, MN
National Provider Identifier
1285164079
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3501 Issued in MN
Practice address
1101 Ninth Street North
Essentia Health Virginia Clinic
Virginia, MN 55792-2329
Phone
(218) 741-0150
NPI assigned
Jun 14, 2017
Last updated
Nov 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3501 MN Primary

Addresses

Primary practice location

1101 Ninth Street North
Essentia Health Virginia Clinic
Virginia, MN 55792-2329

Mailing address

400 East Third Street
Essentia Health Duluth Clinic McL2Cred
Duluth, MN 55805
Phone (218) 786-8319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170627002203 MN Practitioner - Optometry 5294004750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theobald Family Eye Care, LLPGroup PAC ID 4981621745, 3 clinicians

Practice addresses (Care Compare)

416 N Central Ave
Duluth, MN 55807-2548
Phone (218) 624-2095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3501MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Theobald Family Eye Care, LLP Optometrist CurrentSince Apr 8, 2019 Accepting new patients
Duluth Graduate Medical Education Council Inc Past Accepting new patients
The Duluth Clinic, LTD Optometrist Past Accepting new patients
Theobald Family Eye Care, LLP Optometrist PastSince Apr 8, 2019 Accepting new patients

Locations

3308 W Arrowhead Rd
Duluth, MN 55811
Phone (218) 722-8008

3308 W Arrowhead Rd
Ste 1
Duluth, MN 55811

416 N Central Ave
Duluth, MN 55807
Phone (218) 624-2095

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1285164079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST THIRD STREET",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NINTH STREET NORTH",
            "address_2": "ESSENTIA HEALTH VIRGINIA CLINIC",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922329",
            "telephone_number": "218-741-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUER",
        "first_name": "WHITNEY",
        "middle_name": "PAGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia, MN

Sources for this page

Verify at the official NPI Registry.