Active NPI
Northwest Eye Clinic, LLC
- Eyewear Supplier
- Wayzata, MN
National Provider Identifier
1730083155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- NORTHWEST EYE CLINIC, LLC
- Practice address
- 1903 Wayzata Blvd Ste 110
Wayzata, MN 55391-2047 - Phone
- (763) 416-7600
- Fax
- (763) 416-7634
- NPI assigned
- Oct 7, 2026
- Last updated
- Oct 8, 2026
- 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
- Clifton Chad Bazhaw
- Title
- Chief Revenue Officer
- Phone
- (214) 893-0471
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
1903 Wayzata Blvd Ste 110
Wayzata, MN 55391-2047
Mailing address
8401 Golden Valley Rd Ste 330
Golden Valley, MN 55427-4488
Phone (763) 416-7600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791331200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1791417600000",
"number": "1730083155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8401 GOLDEN VALLEY RD STE 330",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554274488",
"telephone_number": "763-416-7600",
"fax_number": "763-416-7634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1903 WAYZATA BLVD STE 110",
"city": "WAYZATA",
"state": "MN",
"postal_code": "553912047",
"telephone_number": "763-416-7600",
"fax_number": "763-416-7634"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHWEST EYE CLINIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-07",
"last_updated": "2026-10-08",
"certification_date": "2026-10-08",
"status": "A",
"authorized_official_last_name": "BAZHAW",
"authorized_official_first_name": "CLIFTON",
"authorized_official_middle_name": "CHAD",
"authorized_official_title_or_position": "CHIEF REVENUE OFFICER",
"authorized_official_telephone_number": "214-893-0471"
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayzata, MN
- Charles Roger Nolop, DDS
- North Star Counseling and Trauma Specialists, PLLC
- Northland Billing Services
- Northland Dental Partners, PLLC (Shoreline Dentistry of Wayzata)
- Northwest Eye Clinic, LLC
- Northwest Eye Clinic, LLC
- Michael T Nwanna, APRN, PMHNP
- Robinah Kyallisima Nwanna, CNP, PMHNP, APRN
- Amy Lorraine Nystrom, L.AC.
- Erin O'Shaughnessy
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.