Balgemann Optometry Group, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-009189 Issued in IL

Legal business name

BALGEMANN OPTOMETRY GROUP, INC.

Practice address

2515 N Prospect Ave
Suite 100
Champaign, IL 61822-1226

Phone

(217) 378-2934

Fax

(217) 378-2936

NPI assigned

Feb 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Garrett Balgemann, O.D.

Title

President

Phone

(217) 864-6191

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1306989553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 N PROSPECT AVE",
            "address_2": "SUITE 100",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221226",
            "telephone_number": "217-378-2934",
            "fax_number": "217-378-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 N PROSPECT AVE",
            "address_2": "SUITE 100",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221226",
            "telephone_number": "217-378-2934",
            "fax_number": "217-378-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALGEMANN OPTOMETRY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "BALGEMANN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GARRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-864-6191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Lennie Baisa, M.D.
• Brady Baker
• Dana Lynn Baker, LCPC
• John P Baker, PHD
• Linda Susan Baker, LPN
• Michael Garrett Balgemann, O.D.
• Randy Allan Ballard, ATC
• Emily Jane Ballew, LPC
• Danielle Baltierra
• David Joshua Banayan, M.D.

• All providers in Champaign, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.