Active NPI
Maureen Whelan, O.D.
- Optometrist
- Bemidji, MN
National Provider Identifier
1437216439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2110
- Practice address
- 1900 Division St W
Bemidji, MN 56601-6396 - Phone
- (218) 759-1430
- Fax
- (218) 444-9086
- NPI assigned
- Jan 2, 2007
- Last updated
- Dec 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2154 | WI | |
| Optometrist | 152W00000X | 2110 | MN | Primary |
Addresses
Primary practice location
1900 Division St W
Bemidji, MN 56601-6396
Mailing address
1900 Division St W
Bemidji, MN 56601-6396
Phone (218) 759-1430
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2200103 | Other | MN | MEDICA |
| DD9612 | Other | MN | RR MEDICARE |
| 4C014WH | Other | MN | BCBS |
| 4C957WH | Other | MN | BCBS NON PAR |
| 548523100 | Medicaid | MN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418601600000",
"number": "1437216439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 DIVISION ST W",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566016396",
"telephone_number": "218-759-1430",
"fax_number": "218-444-9086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 DIVISION ST W",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566016396",
"telephone_number": "218-759-1430",
"fax_number": "218-444-9086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHELAN",
"first_name": "MAUREEN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2014-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2154",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "2110",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "2200103",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "DD9612",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4C014WH",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NON PAR",
"identifier": "4C957WH",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "548523100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bemidji, MN
- Marlee Westrum
- Bailey Michele Wethern, LICSW
- Daniel Ewen Wheeler, M.D.
- Whelan Eye Care, Inc. (White Spruce Optometry)
- Amber Rai Whelan, LADC
- White Earth Band of Ojibwe (Oshki Manidoo MAT Program)
- White Earth Oshki Manidoo New Spirit Center (Oshki Manidoo Center)
- Diane Elaine White
- Mercideze Alexis White, LICSW
- Tara Ann White, OT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.