Sauk Centre Eye Clinic P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2352 Issued in MN

Legal business name

SAUK CENTRE EYE CLINIC P.A.

Practice address

324 Main St S Ste 101
Sauk Centre, MN 56378-1349

Phone

(320) 352-3026

Fax

(320) 352-1164

NPI assigned

Aug 30, 2006

Last updated

Dec 19, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laurie L Holman

Title

Insurance Specialist

Phone

(320) 352-3026

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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.

• Brett Allen Freese, OD

  • Optometrist
  • Sauk Centre, MN
  • NPI 1043260797
  Medicare reassignment NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1376652420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 MAIN ST S STE 101",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "563781349",
            "telephone_number": "320-352-3026",
            "fax_number": "320-352-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 MAIN ST S STE 101",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "563781349",
            "telephone_number": "320-352-3026",
            "fax_number": "320-352-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAUK CENTRE EYE CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "320-352-3026"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Jocelyn Nathe, AU.D.
• Jordan Lynn Michelle Notch, DC
• Sara Amanda Peterson
• Laurette Jane Quistorff, REGISTERED NURSE
• Robert a McDonald Chiropractor LTD (Mainstreet Chiropractic)
• James R. Sayovitz, M.D.
• Kurt Joseph Schiffler, PHARM D
• Wendy Schiffler
• Anna Schmoll, O.D.
• Brendan Schmoll, D.C.

• Optometrist in Sauk Centre, MN
• Providers in Sauk Centre, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.