Black Hills Vision Care Prof LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

T128 Issued in SD

Legal business name

BLACK HILLS VISION CARE PROF LLC

Practice address

1830 5TH Ave
Belle Fourche, SD 57717-2089

Phone

(605) 892-4171

NPI assigned

Oct 22, 2007

Organization subpart

No

Name

James E Trimble, OD

Title

Owner

Phone

(605) 892-2020

• Black Hills Vision Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 24, 2009.

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261612800000",
    "number": "1497944953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 5TH AVE",
            "city": "BELLE FOURCHE",
            "state": "SD",
            "postal_code": "577172089",
            "telephone_number": "605-892-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 5TH AVE",
            "city": "BELLE FOURCHE",
            "state": "SD",
            "postal_code": "577172089",
            "telephone_number": "605-892-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK HILLS VISION CARE PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2009-12-24",
        "status": "A",
        "authorized_official_last_name": "TRIMBLE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-892-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SD",
            "license": "T128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000480182",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112944900",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "429",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201762",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0075127",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Black Hills Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Belle Fourche Nursing and Rehab Center LLC
• Belle Fourche School District 9-1
• Ladonna Raye Bender, CNP
• Allison Bensen, LPC
• Black Hills Optical LLP
• Emily Bleicher, OTD, OTR, LSVT-BIG
• James D Bohl, PA-C
• Alia Brennan
• Butte County Ambulance Service
• Butte County Ambulance Service

• All providers in Belle Fourche, SD
• Optometrist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.