Pietz-Coats Optometry Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

597 Issued in SD

Legal business name

PIETZ-COATS OPTOMETRY INC

Doing business as

The Optical Shop

Practice address

112 22ND Ave S
Brookings, SD 57006-2600

Phone

(605) 692-5173

Fax

(605) 692-6710

NPI assigned

Mar 26, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Susan Jo Pietz, ODNPI 1518918184

Title

President/Optometrist

Phone

(605) 692-5173

Specialties & licenses 1

Addresses

Other names 1

• The Optical Shop Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Practitioners 1

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

• Susan Jo Pietz, O.D.

  • Optometrist
  • Watertown, SD
  • NPI 1518918184
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230076800000",
    "number": "1316119738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 785",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570060785",
            "telephone_number": "605-692-5173",
            "fax_number": "605-692-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 22ND AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062600",
            "telephone_number": "605-692-5173",
            "fax_number": "605-692-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIETZ-COATS OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-12-24",
        "status": "A",
        "authorized_official_last_name": "PIETZ",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "605-692-5173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SD",
            "license": "597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Optical Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clark Gerald Perkins, NCC, LPC
• Jacalyn Person, CSW-PIP
• Alyssa Dawn Peterson, PA-C
• Sara Ruth Peterson, DPT
• Brian L Piearson, OD
• Theresa Plut, MA
• Jackson Roland Pond, OD
• Madelyn Rae Ponto, CNP
• Prairie View Medical, Prof. LLC
• Pro PT, Inc.

• Optometrist in Brookings, SD
• Providers in Brookings, SD by specialty
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.