Active NPI
Soren A. Nywall, O.D.
- Optometrist
- Wisconsin Rapids, WI
National Provider Identifier
1396738563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1687-035
- Practice address
- 1220 Parkwood Drive
Wisconsin Rapids, WI 54494-5488 - Phone
- (715) 421-2111
- Fax
- (715) 421-2123
- NPI assigned
- Aug 23, 2005
- Last updated
- May 13, 2009
- Sex
- Male
- Sole proprietor
- No
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 | 1687-035 | WI | Primary |
Addresses
Primary practice location
1220 Parkwood Drive
Wisconsin Rapids, WI 54494-5488
Mailing address
1220 Parkwood Drive
Wisconsin Rapids, WI 54494-5488
Phone (715) 421-2111
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1687 | WI | MD | Registered Dietitian |
| 1687-035 | WI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242172800000",
"number": "1396738563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 PARKWOOD DRIVE",
"city": "WISCONSIN RAPIDS",
"state": "WI",
"postal_code": "544945488",
"telephone_number": "715-421-2111",
"fax_number": "715-421-2123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 PARKWOOD DRIVE",
"city": "WISCONSIN RAPIDS",
"state": "WI",
"postal_code": "544945488",
"telephone_number": "715-421-2111",
"fax_number": "715-421-2123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYWALL",
"first_name": "SOREN",
"middle_name": "A.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2009-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "1687-035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wisconsin Rapids, WI
- Rodney Noe
- Nancy J Nordstrum, OT
- Northwest Counseling and Guidance Clinic
- Northwest Journey - Wisconsin Rapids Day Treatm
- NSH Wisconsin Rapids LLC (Wisconsin Rapids Health Services)
- Robert K O'Connor, DDS
- Danny Thomas O'Day, CMT
- Michael D. O'Leary, DDS
- Oconnor Chiropractic Office, S.C.
- David Okeefe, M.S., I.S.P.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.