Individual provider Active NPI

Joyce K Mundahl, OD

  • Optometrist
  • Golden Valley, MN
National Provider Identifier
1780662650
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1841 Issued in MN
Practice address
8501 Golden Valley Rd Ste 100
Golden Valley, MN 55427-4472
Phone
(763) 416-7600
Fax
(763) 416-7634
NPI assigned
Jan 2, 2006
Last updated
Mar 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1841 MN Primary

Addresses

Primary practice location

8501 Golden Valley Rd Ste 100
Golden Valley, MN 55427-4472

Mailing address

8401 Golden Valley Rd Ste 100
Golden Valley, MN 55427-4488
Phone (763) 416-7629

Other practice location 1

250 Central Ave N Ste 105
Wayzata, MN 55391-1207
Phone (763) 416-7600

Other practice location 2

12000 Elm Creek Blvd N Ste 100
Maple Grove, MN 55369-7074
Phone (763) 416-7600

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

NPI Registry JSON

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1780662650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 GOLDEN VALLEY RD STE 100",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274488",
            "telephone_number": "763-416-7629",
            "fax_number": "763-383-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 GOLDEN VALLEY RD STE 100",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274472",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Central Ave N Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wayzata",
            "state": "MN",
            "postal_code": "553911207",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12000 Elm Creek Blvd N Ste 100",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553697074",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNDAHL",
        "first_name": "JOYCE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-02",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.