James a. Reedstrom, O.D., LTD.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1511035 Issued in WI

Legal business name

JAMES A. REEDSTROM, O.D., LTD.

Practice address

1325 Tower Ave
Superior, WI 54880-1504

Phone

(715) 394-5722

NPI assigned

Oct 19, 2008

Organization subpart

No

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

Authorized official

Name

James Alan Reedstrom, O.D.

Title

President

Phone

(715) 394-5722

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1224374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249344000000",
    "number": "1417109687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548801504",
            "telephone_number": "715-394-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548801504",
            "telephone_number": "715-394-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES A. REEDSTROM, O.D., LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-19",
        "last_updated": "2009-08-04",
        "status": "A",
        "authorized_official_last_name": "REEDSTROM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-394-5722",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1511035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38563900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Superior, WI
• Providers in Superior, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.

Verify at the official NPI Registry.