Prodigy Optical, Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

PRODIGY OPTICAL, INC

Practice address

314 Ivy Ave SE
Richmond, MN 56368-4509

Phone

(320) 597-5252

Fax

(320) 597-5250

NPI assigned

Oct 11, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Diane Wojtanowicz

Title

Owner

Phone

(320) 597-5252

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1457549800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 IVY AVE SE",
            "address_2": "PO BOX 680",
            "city": "RICHMOND",
            "state": "MN",
            "postal_code": "563684509",
            "telephone_number": "320-597-5252",
            "fax_number": "320-597-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 IVY AVE SE",
            "city": "RICHMOND",
            "state": "MN",
            "postal_code": "563684509",
            "telephone_number": "320-597-5252",
            "fax_number": "320-597-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY OPTICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "WOJTANOWICZ",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-597-5252",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Maas
• Ryan Mareck, DNP
• Danielle Nies
• Corey Douglas Norton, D.C.
• Paynesville Area Hospital District
• Miranda R Proell, CNP
• Kimberly Quittschreiber
• Regional Health Center of Richmond, Inc.
• Charles Chown Reichert, D.D.S.
• Kaitlyn Rae Schlangen, RD

• All providers in Richmond, MN
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.