NPIMap

Organization Active NPI

Crystal View Eye Care

  • Eyewear Supplier
  • Lake Crystal, MN
National Provider Identifier
1740309640
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
2215 Issued in MN
Legal business name
CRYSTAL VIEW EYE CARE
Practice address
102 W Humphrey St
Lake Crystal,, MN 56055-0158
Phone
(507) 726-6639
Fax
(507) 726-6382
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Judith K. Swezey, O.D.NPI 1700943115
Title
Owner--Optometrist
Phone
(507) 726-6639

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2215 MN
Eyewear Supplier 332H00000X 2215 MN Primary

Addresses

Primary practice location

102 W Humphrey St
Lake Crystal,, MN 56055-0158

Mailing address

PO Box 158
102 W Humphrey St
Lake Crystal, MN 56055-0158
Phone (507) 726-6639

Other identifiers 7

IdentifierTypeStateIssuer
114270OtherMNUCARE CLINIC ID#
22-20126OtherMNMEDICA ID#
35770CROtherMNBCBS OF MN CLINIC ID#
248078600MedicaidMN
38204OtherMNHEALTH PARTNERS OFFICE ID
280025000MedicaidMN
4C995CROtherMNBCBS OF MN ID# (PRODUCT)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1740309640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "address_2": "102 W HUMPHREY ST",
            "city": "LAKE CRYSTAL",
            "state": "MN",
            "postal_code": "560550158",
            "telephone_number": "507-726-6639",
            "fax_number": "507-726-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W HUMPHREY ST",
            "city": "LAKE CRYSTAL,",
            "state": "MN",
            "postal_code": "560550158",
            "telephone_number": "507-726-6639",
            "fax_number": "507-726-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL VIEW EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "SWEZEY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER--OPTOMETRIST",
        "authorized_official_telephone_number": "507-726-6639",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2215",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": "2215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE CLINIC ID#",
            "identifier": "114270",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA ID#",
            "identifier": "22-20126",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN CLINIC ID#",
            "identifier": "35770CR",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248078600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS OFFICE ID",
            "identifier": "38204",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280025000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN ID# (PRODUCT)",
            "identifier": "4C995CR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Crystal, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.