Active NPI
Christian Jalen Pratt, OD
- Optometrist
- West Fargo, ND
National Provider Identifier
1326777145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 794
- Practice address
- 505 32ND Ave E Ste B
West Fargo, ND 58078-8490 - Phone
- (701) 566-5390
- Fax
- (701) 539-7199
- NPI assigned
- Jun 7, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 794 | ND | Primary |
Addresses
Primary practice location
505 32ND Ave E Ste B
West Fargo, ND 58078-8490
Mailing address
3101 W 57TH St
Sioux Falls, SD 57108-3162
Phone (605) 371-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1237 N Van Buren St
Unit 401
Milwaukee, WI 53202-4150
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 794 | ND | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vance Thompson Vision ND Prof LLC | Optometrist | Current | Accepting new patients |
Locations
505 32nd Ave E
Ste B
West Fargo, ND 58078
Phone (701) 532-1731
354 23rd Ave E
West Fargo, ND 58078
Phone (701) 566-5390
3101 W 57th St
Sioux Falls, SD 57108
Phone (605) 361-3937
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658102400000",
"number": "1326777145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3101 W 57TH ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571083162",
"telephone_number": "605-371-7100",
"fax_number": "605-371-7199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 32ND AVE E STE B",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580788490",
"telephone_number": "701-566-5390",
"fax_number": "701-539-7199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATT",
"first_name": "CHRISTIAN",
"middle_name": "JALEN",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-07",
"last_updated": "2022-07-18",
"certification_date": "2022-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ND",
"license": "794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.