Active NPI
James A Molde, O.D.
- Optometrist
- Bemidji, MN
National Provider Identifier
1760529408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1728
- Practice address
- 506 Beltrami Ave NW
Bemidji, MN 56601-3010 - Phone
- (218) 751-2020
- Fax
- (218) 759-9228
- NPI assigned
- Jan 31, 2007
- Last updated
- Nov 30, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1728 | MN | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 1728 | MN |
Addresses
Primary practice location
506 Beltrami Ave NW
Bemidji, MN 56601-3010
Mailing address
506 Beltrami Ave NW
Bemidji, MN 56601-3010
Phone (218) 751-2020
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1018420 | Other | PREFERREDONE | |
| 794523000 | Medicaid | MN | |
| 48B51MO | Other | MN | MN BCBS |
| 28771 | Other | ND | ND BCBS |
| HP29311 | Other | HEALTHPARTNERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1728 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1760529408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 BELTRAMI AVE NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566013010",
"telephone_number": "218-751-2020",
"fax_number": "218-759-9228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 BELTRAMI AVE NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566013010",
"telephone_number": "218-751-2020",
"fax_number": "218-759-9228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLDE",
"first_name": "JAMES",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "1728",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "MN",
"license": "1728",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE",
"identifier": "1018420",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "794523000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MN BCBS",
"identifier": "48B51MO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ND BCBS",
"identifier": "28771",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP29311",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Bemidji, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.