Nicollet Vision Care Optometrists P.a.

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

2219 Issued in MN

Legal business name

NICOLLET VISION CARE OPTOMETRISTS P.A.

Practice address

3142 Hennepin Ave S
Minneapolis, MN 55408-2619

Phone

(612) 822-7021

Fax

(612) 822-6123

NPI assigned

Nov 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Linda Marie Chous, O.D.NPI 1205814134

Title

Owner

Phone

(612) 822-7021

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• The Glasses Menagerie Doing business as

Tax ID family

Nicollet Vision Care Optometrists PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nicollet Vision Care Optometrists P.a.

  • Optometrist
  • Minneapolis, MN
  • NPI 1003026923
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Linda M Chous, OD

  • Optometrist
  • Minneapolis, MN
  • NPI 1205814134
  NPD (past) Authorized official

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1760636286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 HENNEPIN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082619",
            "telephone_number": "612-822-7021",
            "fax_number": "612-822-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 HENNEPIN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082619",
            "telephone_number": "612-822-7021",
            "fax_number": "612-822-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLLET VISION CARE OPTOMETRISTS P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "CHOUS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-822-7021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "MN",
            "license": "2219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE",
            "identifier": "102328",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "22-19849",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHP",
            "identifier": "45845",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "610225500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "64637CH",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE PLUS",
            "identifier": "4C348GL",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Glasses Menagerie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicollet Mall Dental Arts PLLC
• Nicollet Pharmacy LLC
• Nicollet Pharmacy LLC
• Nicollet Senior Center Inc
• Nicollet Vision Care Optometrists P.a.
• John J Nicotra, MD
• Yingjiu Nie, M.A.
• Ann Niebuhr, MA
• Lindsey Niederhaus, PHARMD
• Abigail Kathleen Niedorf

• Pediatric Optometrist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.