Northeast Eye Center PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

NORTHEAST EYE CENTER PC

Practice address

404 Hwy 2 E
Devils Lake, ND 58301-0130

Phone

(701) 662-4085

Fax

(701) 662-6010

NPI assigned

Sep 29, 2006

Last updated

Jun 16, 2008By 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

Mr. Robert A Dicken, MDNPI 1568554285

Title

President

Phone

(701) 662-4085

Specialties & licenses 1

Addresses

Other identifiers 4

Practitioners 1

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.

• Robert A Dicken, MD

  • Ophthalmology Physician
  • Devils Lake, ND
  • NPI 1568554285
  Authorized official Same address or phone

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1326130055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583010130",
            "telephone_number": "701-662-4085",
            "fax_number": "701-662-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 HWY 2 E",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583010130",
            "telephone_number": "701-662-4085",
            "fax_number": "701-662-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST EYE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "DICKEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-662-4085",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ND",
            "identifier": "05557001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RETIRED RAILROAD",
            "identifier": "CJ5092",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD MN",
            "identifier": "2F903DO",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17954",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dean Narveson, PA-C
• Bryan C Nelson
• Jennifer Lee Nelson, DPT
• Michelle Nelson
• Hayley Ness
• Jada Nygaard
• Christen Olson, LSW
• Genelle D. Olson, LSW
• Hanna Olson
• Wendy Jo Olson, LSW

• Ophthalmology Physician in Devils Lake, ND
• Providers in Devils Lake, ND by specialty
• Ophthalmology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.