Individual provider Active NPI

Darren Crissler, OD

  • Optometrist
  • Fargo, ND
National Provider Identifier
1376221903
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
810 Issued in ND
Practice address
3402 13TH Ave S
Fargo, ND 58103-6324
Phone
(701) 234-0939
Fax
(701) 234-9442
NPI assigned
Jul 5, 2023
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 810 ND Primary

Addresses

Primary practice location

3402 13TH Ave S
Fargo, ND 58103-6324

Mailing address

3402 13TH Ave S
Fargo, ND 58103-6324

Other practice location 1

3120 25th St S Ste X
Fargo, ND 58103-6110
Phone (701) 234-9768

Other practice location 2

635 32nd Ave E Ste 136
West Fargo, ND 58078-7116
Phone (701) 850-8710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
810NDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
3-D Optical Inc Optometrist CurrentSince Jul 9, 2023 Accepting new patients
I C 20 20 Eau Claire Inc Optometrist PastSince Jul 9, 2023 Accepting new patients

Locations

3120 25th St SW
Ste X
Fargo, ND 58103
Phone (701) 234-9768

3402 13th Ave S
Fargo, ND 58103
Phone (701) 234-0939

635 32nd Ave E
Ste 136
West Fargo, ND 58078
Phone (701) 850-8710

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1376221903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036324",
            "telephone_number": "701-234-0939",
            "fax_number": "701-234-9442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3120 25th St S Ste X",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581036110",
            "country_code": "US",
            "telephone_number": "701-234-9768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "635 32nd Ave E Ste 136",
            "address_purpose": "LOCATION",
            "city": "West Fargo",
            "state": "ND",
            "postal_code": "580787116",
            "country_code": "US",
            "telephone_number": "701-850-8710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISSLER",
        "first_name": "DARREN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "810",
            "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 Jul 5, 2023; 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.