Individual provider Active NPI

David V. Malchow, OD

  • Optometrist
  • Crosby, MN
National Provider Identifier
1689909764
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3239 Issued in MN
Practice address
One 3Rd Avenue NE
Crosby, MN 56441-1667
Phone
(218) 546-5108
Fax
(218) 546-5736
NPI assigned
Oct 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3239 MN Primary

Addresses

Primary practice location

One 3Rd Avenue NE
Crosby, MN 56441-1667

Mailing address

One 3Rd Avenue NE
Crosby, MN 56441-1667
Phone (218) 546-5108

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

NPI Registry JSON

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1689909764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE 3RD AVENUE NE",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411667",
            "telephone_number": "218-546-5108",
            "fax_number": "218-546-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE 3RD AVENUE NE",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411667",
            "telephone_number": "218-546-5108",
            "fax_number": "218-546-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCHOW",
        "first_name": "DAVID",
        "middle_name": "V.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crosby, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.