Drayton Eye Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

421 Issued in ND

Legal business name

DRAYTON EYE CLINIC

Practice address

104 E Highway 66 Ste 102
Drayton, ND 58225-4804

Phone

(701) 454-3340

NPI assigned

Mar 28, 2012

Last updated

Mar 28, 2012By 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

Thomas Dunham, ODNPI 1982601357

Title

Optometrist

Phone

(701) 454-3340

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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.

• Thomas Stephen Dunham, O.D.

  • Optometrist
  • Grand Forks, ND
  • NPI 1982601357
  NPD (past) Authorized official

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1679849236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E HIGHWAY 66 STE 102",
            "city": "DRAYTON",
            "state": "ND",
            "postal_code": "582254804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E HIGHWAY 66 STE 102",
            "city": "DRAYTON",
            "state": "ND",
            "postal_code": "582254804",
            "telephone_number": "701-454-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYTON EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "DUNHAM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "701-454-3340",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ND",
            "license": "421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSI",
            "identifier": "870421 G2",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00568",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60300",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Altru Health System (Altru Clinic - Drayton)
• Catherine Jean Hengel Borud, D.C.
• Catherine J H Borud DC (Drayton Chiropratic)
• Drayton Drug Inc
• Drayton Volunteer Ambulance Association
• Andrew D Duncklee, DDS
• Marlene Kay Gunderson
• Jacqueline K Hoselton
• Corey Merrill

• Clinic/Center in Drayton, ND
• Providers in Drayton, 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 Mar 28, 2012; 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.