Active NPI
Vanessa Manlove
- Optometrist
- Fargo, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 762
- Practice address
- 3051 25TH St S Ste L
Fargo, ND 58103-6102 - Phone
- (701) 234-0766
- NPI assigned
- Sep 20, 2019
- Last updated
- Mar 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 762 | ND | Primary |
Addresses
Primary practice location
3051 25TH St S Ste L
Fargo, ND 58103-6102
Mailing address
1902 25TH Ave S
Fargo, ND 58103-5128
Phone (701) 212-8603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- 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
- Southern College of Optometry, 2019
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
311 Broadway N
Fargo, ND 58102-4714
Phone (701) 540-6444
4541 52 Ave S
Suite 130
Fargo, ND 58104-4465
Phone (701) 929-9028
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 762 | ND | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Vision Centers, Inc | Optometrist | Current | Accepting new patients |
| Vanessa Manlove PLLC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Michael Rexine OD PC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
Locations
738 Kirkwood Mall
Bismarck, ND 58504
Phone (701) 258-8810
3051 25th St S
Ste L
Fargo, ND 58103
Phone (701) 234-0766
311 Broadway N
Fargo, ND 58102
Phone (701) 356-3937
4541 52nd Ave S
Ste 130
Fargo, ND 58104
Phone (701) 929-9028
32 Main St W
Mayville, ND 58257
Phone (701) 786-2666
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Midwest Vision Centers
- Optician
- Morris, MN
- NPI 1073682191
Optometrist
-
dba Fielmann Vision Care 4313
- Eyewear Supplier
- Rockford, IL
- NPI 1467311142
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1376194472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1902 25TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581035128",
"telephone_number": "701-212-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3051 25TH ST S STE L",
"city": "FARGO",
"state": "ND",
"postal_code": "581036102",
"telephone_number": "701-234-0766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANLOVE",
"first_name": "VANESSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-20",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ND",
"license": "762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.