Active NPI
Anne M Jorgensen, OPTICIAN
- Optician
- Sioux Falls, SD
National Provider Identifier
1790061539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Practice address
- 4900 S Minnesota Ave
Suite 105
Sioux Falls, SD 57108-2865 - Phone
- (605) 759-2389
- NPI assigned
- Oct 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary | ||
| Technician/Technologist | 156F00000X | |||
| Contact Lens Technician/Technologist | 156FC0800X | |||
| Ophthalmic Assistant | 156FX1101X | |||
| Optometric Assistant Technician | 156FX1201X | |||
| Optometric Technician | 156FX1202X |
Addresses
Primary practice location
4900 S Minnesota Ave
Suite 105
Sioux Falls, SD 57108-2865
Mailing address
4900 S Minnesota Ave
Suite 105
Sioux Falls, SD 57108-2865
Phone (605) 759-2389
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1026-7978-ST | Other | SD DEPT. OF REVENUE |
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 20/20 Eye Candy, Inc. | Technician/Technologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384128000000",
"number": "1790061539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 S MINNESOTA AVE",
"address_2": "SUITE 105",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571082865",
"telephone_number": "605-759-2389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 S MINNESOTA AVE",
"address_2": "SUITE 105",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571082865",
"telephone_number": "605-759-2389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORGENSEN",
"first_name": "ANNE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-25",
"last_updated": "2013-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
},
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "156FC0800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Contact Lens",
"state": null,
"license": null,
"primary": false
},
{
"code": "156FX1101X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ophthalmic Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "156FX1201X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optometric Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "156FX1202X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optometric Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SD DEPT. OF REVENUE",
"identifier": "1026-7978-ST",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.