Charles R Mead

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CHARLES R MEAD

Practice address

1502 Woodlane Dr
Woodbury, MN 55125-2221

Phone

(651) 735-9550

Fax

(651) 735-9322

NPI assigned

Apr 5, 2010

Last updated

Apr 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Audrey Mead

Title

Practice Manager

Phone

(651) 735-9550

Specialties & licenses 7

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1306161187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 WOODLANE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252221",
            "telephone_number": "651-735-9550",
            "fax_number": "651-735-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 WOODLANE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252221",
            "telephone_number": "651-735-9550",
            "fax_number": "651-735-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES R MEAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "MEAD",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "651-735-9550"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1202X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optometric Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "25841ME",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "568938300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "97365062201",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cathy L Chavez, LICSW
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• Optometrist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; 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.