LG Optical Enterprises

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

05001593786886EST001 Issued in SD

Legal business name

LG OPTICAL ENTERPRISES

Practice address

952 22ND Ave S
Brookings, SD 57006-2830

Phone

(605) 692-8262

Fax

(605) 692-9805

NPI assigned

Mar 4, 2008

Organization subpart

No

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

Authorized official

Name

Lynn Gannon

Title

Owner

Phone

(605) 692-8262

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Total Eyewear Doing business as

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jarrell Freitag, OD

  • Optometrist
  • Sioux Falls, SD
  • NPI 1013401637
  NPD (past)
• Micah Hoellein, OD

  • Optometrist
  • Watertown, SD
  • NPI 1588408850
  NPD (past)
• Kristen Kramlich, O.D.

  • Optometrist
  • Sioux Falls, SD
  • NPI 1427408798
  NPD (past)
• Wyatt Nash-Keller, O.D.

  • Optometrist
  • Brookings, SD
  • NPI 1124371992
  NPD (past)
• Kyle Porisch, OD

  • Optometrist
  • Huron, SD
  • NPI 1275625071
  NPD (past)

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1306016407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062830",
            "telephone_number": "605-692-8262",
            "fax_number": "605-692-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "952 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062830",
            "telephone_number": "605-692-8262",
            "fax_number": "605-692-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LG OPTICAL ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-692-8262"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "SD",
            "license": "05001593786886EST001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "111835",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4997613",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTA CARE",
            "identifier": "9226299",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "39879",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9281452",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Total Eyewear",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Larkspur Counseling & Therapy, LLC
• Spencer Laufmann, DPT
• Catherine A Leadabrand, MD
• Allison Leonard, ATC
• Katharine Marie Leuthold, ATC
• Ashley Lauren Lipp, PA-C
• Little Wildflower Play Therapy, LLC
• Dustin Wade Little, DPT, CSCS
• Ellie Alayne Livingston
• Maureen A. Logue

• All providers in Brookings, SD
• Eyewear Supplier in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.