Active NPI
Spearfish Vision Works, P.C.
- Optometrist
- Spearfish, SD
National Provider Identifier
1720190457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 624
- Legal business name
- SPEARFISH VISION WORKS, P.C.
- Practice address
- 2825 1St Ave
Spearfish, SD 57783-3261 - Phone
- (605) 642-3865
- Fax
- (605) 642-3891
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Brian Keith Gill, O.D.
- Title
- President
- Phone
- (605) 484-1977
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 624 | SD | Primary |
Addresses
Primary practice location
2825 1St Ave
Spearfish, SD 57783-3261
Mailing address
2825 1St Ave
Spearfish, SD 57783-3261
Phone (605) 642-3865
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285657742 | Other | SD | NPI (PERSONAL) |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Optometrist
- Belle Fourche, SD
- NPI 1447664800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070627000668 | SD | Part B Supplier - Clinic/Group Practice | 4385649482 |
Receives reassigned benefits from 1 practitioner 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Belle Fourche, SD |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198108800000",
"number": "1720190457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 1ST AVE",
"city": "SPEARFISH",
"state": "SD",
"postal_code": "577833261",
"telephone_number": "605-642-3865",
"fax_number": "605-642-3891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 1ST AVE",
"city": "SPEARFISH",
"state": "SD",
"postal_code": "577833261",
"telephone_number": "605-642-3865",
"fax_number": "605-642-3891"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPEARFISH VISION WORKS, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-31",
"last_updated": "2007-12-20",
"status": "A",
"authorized_official_last_name": "GILL",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "KEITH",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "605-484-1977",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "SD",
"license": "624",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI (PERSONAL)",
"identifier": "1285657742",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spearfish, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.