Quarry Optical, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

609 Issued in SD

Legal business name

QUARRY OPTICAL, INC.

Practice address

153 Division St
Suite a
Waite Park, MN 56387

Phone

(320) 251-2020

Fax

(320) 252-7416

NPI assigned

Dec 11, 2014

Organization subpart

No

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

Authorized official

Name

Chad Beynon, O.D.

Title

President

Phone

(605) 882-2020

Specialties & licenses 1

Addresses

Other names 2

• Pearle Vision Doing business as
• Beynon Enterprises, PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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

• Jared Jay Fairbanks, O.D.

  • Optometrist
  • Willmar, MN
  • NPI 1881031524
  Medicare reassignment
• Melissa Anna Shaffer, O.D.

  • Optometrist
  • Saint Cloud, MN
  • NPI 1285833624
  Medicare reassignment
• Sally Beth Jackula, OD

  • Optometrist
  • Saint Cloud, MN
  • NPI 1902804149
  NPD (past)

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1811395544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 DIVISION ST",
            "address_2": "SUITE A",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "56387",
            "telephone_number": "320-251-2020",
            "fax_number": "320-252-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 DIVISION ST",
            "address_2": "SUITE A",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "56387",
            "telephone_number": "320-251-2020",
            "fax_number": "320-252-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUARRY OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-11",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "BEYNON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-882-2020",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SD",
            "license": "609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beynon Enterprises, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Allison Jean Grace Potts
• Makayla Preusser
• Processus P.a.
• Kelsey Ann Provo
• Rachael Anne Quaintance
• Abdukadir Rabi
• Cheri Tara Ram
• Angelica Ramey
• Timothy R Rasmussen, MD
• Hailey Elizabeth Rausch

• Optometrist in Waite Park, MN
• Providers in Waite Park, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.