Active NPI
Harlan Jay Vander Griend, OD
- Optometrist
- Sheldon, IA
National Provider Identifier
1811964794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1668
- Practice address
- 928 3Rd Avenue
Sheldon, IA 51201-0100 - Phone
- (712) 324-2552
- Fax
- (712) 324-2553
- NPI assigned
- Mar 1, 2006
- Last updated
- Dec 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1668 | IA | Primary |
Addresses
Primary practice location
928 3Rd Avenue
Sheldon, IA 51201-0100
Mailing address
928 3Rd Avenue
PO Box 100
Sheldon, IA 51201-0100
Phone (712) 324-2552
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I7584 | Other | IA | MEDICARE GROUP SHELDON |
| 2161778 | Other | IA | MEDICAID INDV PAULLINA |
| 11753 | Other | IA | WELLMARK INDV PAULLINA |
| 0280578 | Other | IA | MEDICAID GROUP PAULLINA |
| 0280586 | Medicaid | IA | |
| 16177 | Other | IA | MEDICARE INDV SHELDON |
| CE1831 | Other | IA | RR MEDICARE GROUP PAULLIN |
| I7585 | Other | IA | MEDICARE GROUP PAULLINA |
| 0280586 | Other | IA | MEDICAID GROUP SHELDON |
| 11753 | Other | IA | MEDICARE INDV PAULLINA |
| 33330 | Other | IA | WELLMARK GROUP SHELDON |
| 33340 | Other | IA | WELLMARK GROUP PAULLINA |
| CS7580 | Other | IA | RR MEDICARE GROUP SHELDON |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1668 | IA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197504000000",
"number": "1811964794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "928 3RD AVENUE",
"address_2": "PO BOX 100",
"city": "SHELDON",
"state": "IA",
"postal_code": "512010100",
"telephone_number": "712-324-2552",
"fax_number": "712-324-2553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 3RD AVENUE",
"city": "SHELDON",
"state": "IA",
"postal_code": "512010100",
"telephone_number": "712-324-2552",
"fax_number": "712-324-2553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDER GRIEND",
"first_name": "HARLAN",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2007-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IA",
"license": "1668",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP SHELDON",
"identifier": "I7584",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID INDV PAULLINA",
"identifier": "2161778",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK INDV PAULLINA",
"identifier": "11753",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP PAULLINA",
"identifier": "0280578",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0280586",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE INDV SHELDON",
"identifier": "16177",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP PAULLIN",
"identifier": "CE1831",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PAULLINA",
"identifier": "I7585",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP SHELDON",
"identifier": "0280586",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE INDV PAULLINA",
"identifier": "11753",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK GROUP SHELDON",
"identifier": "33330",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK GROUP PAULLINA",
"identifier": "33340",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP SHELDON",
"identifier": "CS7580",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sheldon, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.