Jordan Diane Muir, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

747 Issued in ND

Practice address

1300 Gateway Dr S
Fargo, ND 58103-3509

Phone

(701) 235-0280

Fax

(701) 235-3326

NPI assigned

Jun 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

20-20 Vision Express LLCGroup PAC ID 8022269430, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• 20-20 Vision Express LLC

  • Clinic/Center
  • Fargo, ND
  • NPI 1922350636
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1699125765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 GATEWAY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033509",
            "telephone_number": "701-235-0280",
            "fax_number": "701-235-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 GATEWAY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033509",
            "telephone_number": "701-235-0280",
            "fax_number": "701-235-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUIR",
        "first_name": "JORDAN",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3479",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Sue Muellner, RN, BSN
• Josh Edward Muellner
• Fashingoma Mugisha
• Rihan Muhammed, MD
• Aline Bernardine Muhimpundu
• Kerry L Muir, P.T.
• Williemina Mulbah
• Sarah Michelle Mulcahy, RN
• Madalyn Muldoon
• Jennifer Lynn Mullally, MD

• Optometrist in Fargo, ND
• Providers in Fargo, ND by specialty
• Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.