NPIMap

Organization Active NPI

Northern Refractive Surgery Center LTD

  • Ophthalmology Physician
  • Hermantown, MN
National Provider Identifier
1700899457
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NORTHERN REFRACTIVE SURGERY CENTER LTD
Practice address
4815 W Arrowhead Rd
Suite 120
Hermantown, MN 55811-4004
Phone
(218) 625-1917
Fax
(218) 625-7182
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Jeffrey Ross Weis, MDNPI 1821183815
Title
Owner Physician
Phone
(218) 625-1917

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4815 W Arrowhead Rd
Suite 120
Hermantown, MN 55811-4004

Mailing address

4815 W Arrowhead Rd
Suite 120
Hermantown, MN 55811-4004
Phone (218) 625-1917

Other identifiers 1

IdentifierTypeStateIssuer
3F033BEOtherMNBLUE CROSS BLUE SHIELD

Other names 1

  • Northern Eye Institute Doing business as

National Provider Directory

National Provider Directory

Locations

4815 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 625-1917

4815 W Arrowhead Rd
Ste 120
Hermantown, MN 55811
Phone (218) 625-1917

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1700899457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 W ARROWHEAD RD",
            "address_2": "SUITE 120",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558114004",
            "telephone_number": "218-625-1917",
            "fax_number": "218-625-7182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 W ARROWHEAD RD",
            "address_2": "SUITE 120",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558114004",
            "telephone_number": "218-625-1917",
            "fax_number": "218-625-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN REFRACTIVE SURGERY CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "WEIS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "218-625-1917",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3F033BE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermantown, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.