NPIMap

Organization Active NPI

Larry Bonderud & Mark Stanchfield Optometrists

  • Optometrist
  • Conrad, MT
National Provider Identifier
1295850535
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
516 Issued in MT
Legal business name
LARRY BONDERUD & MARK STANCHFIELD OPTOMETRISTS
Practice address
19 4TH Ave SW
Conrad, MT 59425-2339
Phone
(406) 271-5517
Fax
(406) 271-5518
NPI assigned
Mar 19, 2007
Last updated
Jul 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Authorized official

Name
Dr. Larry James Bonderud, O.D.NPI 1164414322
Title
Owner
Phone
(406) 434-5196

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
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 393 MT
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 516 MT Primary

Addresses

Primary practice location

19 4TH Ave SW
Conrad, MT 59425-2339

Mailing address

PO Box 815
Conrad, MT 59425-0815
Phone (406) 271-5517

National Provider Directory

National Provider Directory

Locations

19 4th Ave SW
Conrad, MT 59425
Phone (406) 271-5517

Practitioners & affiliated clinicians

Practitioners 2

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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1295850535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 815",
            "city": "CONRAD",
            "state": "MT",
            "postal_code": "594250815",
            "telephone_number": "406-271-5517",
            "fax_number": "406-271-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 4TH AVE SW",
            "city": "CONRAD",
            "state": "MT",
            "postal_code": "594252339",
            "telephone_number": "406-271-5517",
            "fax_number": "406-271-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY BONDERUD & MARK STANCHFIELD OPTOMETRISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "BONDERUD",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-434-5196",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MT",
            "license": "393",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MT",
            "license": "516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conrad, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.