Organization Active NPI

Northway Eye & Contact Lens Center

  • Optometrist
  • Saint Cloud, MN
National Provider Identifier
1396814539
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2909 Issued in MN
Legal business name
NORTHWAY EYE & CONTACT LENS CENTER
Practice address
1545 Northway Dr
Suite 120
Saint Cloud, MN 56303-1940
Phone
(320) 253-2441
Fax
(320) 253-2446
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Natalie Mary Guggenberger
Title
Office Manager
Phone
(320) 253-2441

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1776 MN
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 2751 MN
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 2909 MN Primary

Addresses

Primary practice location

1545 Northway Dr
Suite 120
Saint Cloud, MN 56303-1940

Mailing address

1545 Northway Dr
Suite 120
Saint Cloud, MN 56303-1940
Phone (320) 253-2441

National Provider Directory

National Provider Directory

Locations

1545 Northway Dr
Ste 120
Saint Cloud, MN 56303
Phone (320) 253-2441

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396814539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 NORTHWAY DR",
            "address_2": "SUITE 120",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031940",
            "telephone_number": "320-253-2441",
            "fax_number": "320-253-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 NORTHWAY DR",
            "address_2": "SUITE 120",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031940",
            "telephone_number": "320-253-2441",
            "fax_number": "320-253-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWAY EYE & CONTACT LENS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUGGENBERGER",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "320-253-2441"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1776",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2751",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.