Southern Montana Optometric Center, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

523 Issued in MT

Legal business name

SOUTHERN MONTANA OPTOMETRIC CENTER, INC

Practice address

210 1St Ave
Laurel, MT 59044-3014

Phone

(406) 628-8668

Fax

(406) 628-8668

NPI assigned

Feb 7, 2007

Last updated

Nov 15, 2007By 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. Ronald Lee Benner, ODNPI 1710037437

Title

President

Phone

(406) 628-8668

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

Practitioners 3

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.

• Ronald Lee Benner, O.D.

  • Optometrist
  • Laurel, MT
  • NPI 1710037437
  Medicare reassignment NPD Authorized official
• Jennifer H. Dull, O.D.

  • Optometrist
  • Billings, MT
  • NPI 1124165618
  NPD (past)
• Sam Hoffmann, O.D.

  • Optometrist
  • Sheridan, WY
  • NPI 1962434886
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1619017928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "LAUREL",
            "state": "MT",
            "postal_code": "590440190",
            "telephone_number": "406-628-8668",
            "fax_number": "406-628-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 1ST AVE",
            "city": "LAUREL",
            "state": "MT",
            "postal_code": "590443014",
            "telephone_number": "406-628-8668",
            "fax_number": "406-628-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MONTANA OPTOMETRIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "BENNER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-628-8668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MT",
            "license": "523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kayla Ashley Stewart, O.D., M.ED.
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• Erica Stokke, D.D.S.
• Samuel Lee Stokke, DDS
• Jay Donald Talbot, D.D.S.

• Optometrist in Laurel, MT
• Providers in Laurel, MT by specialty
• Optometrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.