Soderberg Eye Care Center

Primary specialty

OptometristTaxonomy code 152W00000X

License

1396 Issued in WI

Legal business name

SODERBERG EYE CARE CENTER

Practice address

228 Paperjack Dr
New Richmond, WI 54017-2430

Phone

(715) 246-4441

Fax

(715) 246-3250

NPI assigned

Sep 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Raymond Soderberg, O.D.NPI 1649235524

Title

President

Phone

(715) 246-4441

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Dennis R. Soderberg O.D. Other name

Practitioners 1

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

• Dennis Raymond Soderberg, O.D.

  • Optometrist
  • Baldwin, WI
  • NPI 1649235524
  NPD (past) Authorized official

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346344678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 PAPERJACK DR",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540172430",
            "telephone_number": "715-246-4441",
            "fax_number": "715-246-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 PAPERJACK DR",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540172430",
            "telephone_number": "715-246-4441",
            "fax_number": "715-246-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SODERBERG EYE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SODERBERG",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-246-4441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "22-14005",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "371170106044",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38501900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "48421",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dennis R. Soderberg O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Krista Lee Sikorski, PA-C
• Jeffery Simpkins, CRNA
• Julie Simpson
• Courtney Aron Smith
• Jessica Rose Smith, DPT
• Sarah Marie Soderberg, MSE, CCC-SLP
• Melvin Solsvig Sr., CSAC
• Sonya'S Employment Options LLC
• Sonya'S Employment Options LLC
• Kelli L Sosnowski, SAC-IT

• Optometrist in New Richmond, WI
• Providers in New Richmond, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.