Eyewear Specialists Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

4699580 Issued in MN

Legal business name

EYEWEAR SPECIALISTS INC

Practice address

560 S Maple St
Suite 110
Waconia, MN 55387-1763

Phone

(952) 442-4445

Fax

(952) 442-2455

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Cheryl Mayne

Title

RCM Manager

Phone

(952) 832-8100

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1396864146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 FRANCE AVE S",
            "address_2": "SUITE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354787",
            "telephone_number": "952-832-8120",
            "fax_number": "952-832-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 S MAPLE ST",
            "address_2": "SUITE 110",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871763",
            "telephone_number": "952-442-4445",
            "fax_number": "952-442-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEWEAR SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "MAYNE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "952-832-8100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": "4699580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51083CL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0683720007",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "170631",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Matthew Feriancek, D.C.
• Spencer R Ferrell, MD
• Evan Fillingane

• Eyewear Supplier in Waconia, MN
• Providers in Waconia, MN by specialty
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.