Individual provider Active NPI

Delmar E Spronk, O.D.

  • Optometrist
  • Sheldon, IA
National Provider Identifier
1619948528
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1630 Issued in IA
Practice address
928 3Rd Ave
Sheldon, IA 51201-0100
Phone
(712) 324-2552
NPI assigned
Jan 30, 2006
Last updated
Dec 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1630 IA Primary

Addresses

Primary practice location

928 3Rd Ave
Sheldon, IA 51201-0100

Mailing address

928 3Rd Ave
PO Box 100
Sheldon, IA 51201-0100
Phone (712) 324-2552

Other identifiers 15

IdentifierTypeStateIssuer
0280578MedicaidIA
1158659MedicaidIA
23060OtherIAMEDICARE DME INDIV ID-PAU
410032855OtherIARR MEDICARE INDIV PAULLIN
CE1831OtherIARR MEDICARE GROUP PAULLIN
I7585OtherIAMEDICARE GROUP PAULLINA
I7584OtherIAMEDICARE GROUP ID-SHELDON
33330OtherIAWELLMARK GROUP ID
0158659MedicaidIA
410021693OtherIARR MEDICARE INDI SHELDON
0280586MedicaidIA
15865OtherIAMEDICARE DME INDV ID-SHEL
23060OtherIAMEDICARE INDIVIDUAL PAULL
33340OtherIAWELLMARK GROUP ID
CS7580OtherIARR MEDICARE GROUP SHELDON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1630IAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1619948528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 3RD AVE",
            "address_2": "PO BOX 100",
            "city": "SHELDON",
            "state": "IA",
            "postal_code": "512010100",
            "telephone_number": "712-324-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 3RD AVE",
            "city": "SHELDON",
            "state": "IA",
            "postal_code": "512010100",
            "telephone_number": "712-324-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRONK",
        "first_name": "DELMAR",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280578",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1158659",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME INDIV ID-PAU",
            "identifier": "23060",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIV PAULLIN",
            "identifier": "410032855",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP PAULLIN",
            "identifier": "CE1831",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PAULLINA",
            "identifier": "I7585",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID-SHELDON",
            "identifier": "I7584",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK GROUP ID",
            "identifier": "33330",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0158659",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDI SHELDON",
            "identifier": "410021693",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280586",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME INDV ID-SHEL",
            "identifier": "15865",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PAULL",
            "identifier": "23060",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK GROUP ID",
            "identifier": "33340",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP SHELDON",
            "identifier": "CS7580",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheldon, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.