Organization Active NPI

DRS. Akre & Clark, LTD.

  • Optometrist
  • Springfield, MN
National Provider Identifier
1376180109
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DRS. AKRE & CLARK, LTD.
Practice address
623 W Rock St
Springfield, MN 56087-1028
Phone
(507) 354-8531
NPI assigned
Nov 27, 2019
Last updated
Apr 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Authorized official

Name
Thomas Eugene Clark, ODNPI 1427044692
Title
President
Phone
(507) 354-8531

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

623 W Rock St
Springfield, MN 56087-1028

Mailing address

PO Box 727
New Ulm, MN 56073-0727
Phone (507) 354-8531

Other identifiers 1

IdentifierTypeStateIssuer
484301100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191220002175 MN DME Supplier - Physician - Optometrist 5698762714 Practice locations: Springfield, MN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2168991DRS Akre & Clark623 W Rock St, Springfield, MN 56087Certificate of waiverJul 12, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
DRS. Akre and Clark, LTD623 W Rock St, Springfield, MN 56087-1028(507) 723-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1996

National Provider Directory

National Provider Directory
Tax ID family
DRS Akre Clark LTD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1376180109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "560730727",
            "telephone_number": "507-354-8531",
            "fax_number": "507-359-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 W ROCK ST",
            "city": "SPRINGFIELD",
            "state": "MN",
            "postal_code": "560871028",
            "telephone_number": "507-354-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. AKRE & CLARK, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-27",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-354-8531",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "484301100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.