David G Gaustad

Primary specialty

OpticianTaxonomy code 156FX1800X

License

025206 Issued in MN

Practice address

615 S Mill St
Suite 2
Fergus Falls, MN 56537-2756

Phone

(218) 998-2020

Fax

(218) 998-2098

NPI assigned

Nov 18, 2009

Last updated

Nov 18, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• 20-20 Optical Inc

  • Eyewear Supplier
  • Fergus Falls, MN
  • NPI 1619972734

  Optician

  NPD Authorized official
• Eye 2 Eye Optical

  • Eyewear Supplier
  • Fergus Falls, MN
  • NPI 1609514637
  NPD Authorized official

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1720316409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 LAKEWOOD DR",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373948",
            "telephone_number": "218-736-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S MILL ST",
            "address_2": "SUITE 2",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372756",
            "telephone_number": "218-998-2020",
            "fax_number": "218-998-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUSTAD",
        "first_name": "DAVID",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "MN",
            "license": "025206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MN",
            "identifier": "4C853GA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Fuller, RN
• Donald Ganoe, RPH
• Aleisha Ann Gardin
• Mattea Gardner
• Gary a Matthys MD PLC (Matthys Orthopaedic Center)
• Carla Errolyn Gauwitz, L.P.N.
• Melissa Gedrose, LICSW
• Dawn Marie Gehrke
• Patricia Jane Gehrls
• Generations, Inc Counseling Associates

• Optician in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Optician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.