Eyewearspecialists

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

4699580 Issued in MN

Legal business name

EYEWEARSPECIALISTS

Practice address

111 Hundertmark Rd
Suite 105N
Chaska, MN 55318-4551

Phone

(952) 906-7824

Fax

(952) 906-7827

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Cheryl Mayne

Title

RCM Manager

Phone

(952) 832-8100

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1285713420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 FRANCE AVE S",
            "address_2": "SUITE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354787",
            "telephone_number": "952-832-8120",
            "fax_number": "952-832-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD",
            "address_2": "SUITE 105N",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553184551",
            "telephone_number": "952-906-7824",
            "fax_number": "952-906-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEWEARSPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "MAYNE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "952-832-8100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": "4699580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51083CL",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1251147-00",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "170631",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "21-00712",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Maria Erickson, LICSW
• Laurel L Erickson, M.D.
• David Erlandson, DPT
• Stephanie Ess, MA, LMFT
• Julie Elizabeth Ewasiuk, MD
• Fabian Homecare LLC
• Colleen Fafinski, LP
• Fairview Express Care
• Family Therapy Specialists, Inc
• Zakaria Farah

• All providers in Chaska, MN
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.