Eye Center of the Dakotas, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EYE CENTER OF THE DAKOTAS, PC

Doing business as

Eye Center of the Dakotas

Practice address

1221 W Divide Ave
Ste 1
Bismarck, ND 58501-1224

Phone

(701) 224-0661

Fax

(701) 224-0663

NPI assigned

Sep 25, 2006

Last updated

Jul 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert D. Nordstrom, O.D.

Title

Owner

Phone

(701) 224-0661

Specialties & licenses 1

Addresses

Other names 1

• Eye Center of the Dakotas Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kellen Elaine Pathroff, O.D.

  • Optometrist
  • Bismarck, ND
  • NPI 1588004592
  Medicare reassignment Care Compare group NPD
• Timothy L Tello, OD

  • Optometrist
  • Bismarck, ND
  • NPI 1346348000
  Medicare reassignment Care Compare group NPD
• Danelle F Moch, O.D.

  • Optometrist
  • Bismarck, ND
  • NPI 1255323796
  Medicare reassignment Care Compare group
• Kari J Burgard, OD

  • Optometrist
  • St Anthony, MN
  • NPI 1164713392

  ND

  Medicare reassignment NPD

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1548360761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W DIVIDE AVE",
            "address_2": "STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011224",
            "telephone_number": "701-224-0661",
            "fax_number": "701-224-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W DIVIDE AVE",
            "address_2": "STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011224",
            "telephone_number": "701-224-0661",
            "fax_number": "701-224-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTER OF THE DAKOTAS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "NORDSTROM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-224-0661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Center of the Dakotas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.