Dr. Thomas M. Kilzer - Optometerist - PC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

332 Issued in ND

Legal business name

DR. THOMAS M. KILZER - OPTOMETERIST - PC

Practice address

1929 N Washington St
Bismarck, ND 58501-1616

Phone

(701) 258-6100

Fax

(701) 258-9882

NPI assigned

Jun 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Thomas M Kilzer, O.D.

Title

President

Phone

(701) 258-6100

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1396907010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 N WASHINGTON ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011616",
            "telephone_number": "701-258-6100",
            "fax_number": "701-258-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 N WASHINGTON ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011616",
            "telephone_number": "701-258-6100",
            "fax_number": "701-258-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. THOMAS M. KILZER - OPTOMETERIST - PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "KILZER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-258-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "ND",
            "license": "332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60138",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Bismarck, ND
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.