Individual provider Active NPI

Christine Jane Janty, OD

  • Optometrist
  • Minneapolis, MN
National Provider Identifier
1710058243
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2041 Issued in MN
Practice address
410 Church St SE
Boynton Health Service
Minneapolis, MN 55455-0340
Phone
(612) 625-8400
Fax
(612) 625-1434
NPI assigned
Nov 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 2041 MN Primary

Addresses

Primary practice location

410 Church St SE
Boynton Health Service
Minneapolis, MN 55455-0340

Mailing address

410 Church St SE
Minneapolis, MN 55455-0340
Phone (612) 625-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20100824000899 MN Practitioner - Optometry 5092839365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2041MNMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota CurrentSince Jul 12, 2010 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients
Regents of the University of Minnesota CurrentSince Jul 12, 2010 Accepting new patients

Locations

410 Church St SE
Minneapolis, MN 55455
Phone (612) 625-8400

410 Church St SE
#W235
Minneapolis, MN 55455

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710058243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550340",
            "telephone_number": "612-625-8400",
            "fax_number": "612-625-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "address_2": "BOYNTON HEALTH SERVICE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550340",
            "telephone_number": "612-625-8400",
            "fax_number": "612-625-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANTY",
        "first_name": "CHRISTINE",
        "middle_name": "JANE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.