Chad Dockter OD LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CHAD DOCKTER OD LTD

Practice address

8225 Flying Cloud Dr
Eden Prairie, MN 55344-5315

Phone

(952) 563-0246

NPI assigned

Jun 11, 2009

Organization subpart

No

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

Authorized official

Name

Chad Ray Dockter, OD

Title

Optometrist

Phone

(952) 448-6560

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1508093063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 RAMSEY AVE",
            "city": "CARVER",
            "state": "MN",
            "postal_code": "553154515",
            "telephone_number": "952-448-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8225 FLYING CLOUD DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445315",
            "telephone_number": "952-563-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAD DOCKTER OD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "DOCKTER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "952-448-6560",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Clinic/Center in Minnesota

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