J and D Optical Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

J AND D OPTICAL INC.

Doing business as

Third Street Optical

Practice address

212 3Rd St NW
Bemidji, MN 56601-3112

Phone

(218) 751-8313

Fax

(218) 444-3385

NPI assigned

Jul 3, 2006

Organization subpart

No

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

Authorized official

Name

David R Smith

Title

VP Finance

Phone

(218) 751-8313

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Third Street Optical Doing business as

Locations

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1801825476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 3RD ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013112",
            "telephone_number": "218-751-8313",
            "fax_number": "218-444-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 3RD ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013112",
            "telephone_number": "218-751-8313",
            "fax_number": "218-444-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J AND D OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "218-751-8313"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "81410DU",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926563500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Third Street Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optician in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Optician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.