Organization Active NPI

Huron Eye Clinic PC

  • Optometrist
  • Huron, SD
National Provider Identifier
1386616480
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T112 Issued in SD
Legal business name
HURON EYE CLINIC PC
Practice address
1288 Dakota Ave S
Ste 3
Huron, SD 57350-0948
Phone
(605) 352-4181
Fax
(605) 352-4189
NPI assigned
Feb 2, 2006
Last updated
Feb 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
Mr. James L Nelson, ODNPI 1841302700
Title
President
Phone
(605) 352-4181

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
Optometrist 152W00000X T112 SD Primary

Addresses

Primary practice location

1288 Dakota Ave S
Ste 3
Huron, SD 57350-0948

Mailing address

PO Box 948
Huron, SD 57350-0948
Phone (605) 352-4181

Other identifiers 2

IdentifierTypeStateIssuer
9201065MedicaidSD
0041041OtherSDWELLMARK BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040603001110 SD Part B Supplier - Clinic/Group Practice 7911989876 Receives reassigned benefits from 3 practitioners
Practice locations: Huron, SD
O20100930098802 SD DME Supplier - Physician - Optometrist 7911989876 Practice locations: Huron, SD

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Huron Eye Clinic PC1288 Dakota Ave S, Huron, SD 57350-3675(609) 352-4181 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since May 1, 2003

National Provider Directory

National Provider Directory

Locations

1288 Dakota Ave S
Ste 3
Huron, SD 57350
Phone (605) 352-4181

Practitioners & affiliated clinicians

Practitioners 3

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": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1386616480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 948",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573500948",
            "telephone_number": "605-352-4181",
            "fax_number": "605-352-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 DAKOTA AVE S",
            "address_2": "STE 3",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573500948",
            "telephone_number": "605-352-4181",
            "fax_number": "605-352-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURON EYE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-352-4181",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "T112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201065",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "0041041",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huron, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.