Fifth Avenue of Edina Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1456 Issued in MN

Legal business name

FIFTH AVENUE OF EDINA INC.

Practice address

3540 Galleria
Edina, MN 55435-4218

Phone

(952) 922-1052

Fax

(952) 922-2518

NPI assigned

Nov 26, 2008

Last updated

Jun 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gale L Stead, O.D.NPI 1578515102

Title

Owner

Phone

(952) 922-1052

Specialties & licenses 2

Addresses

Other names 1

• FIFTH AVENUE OPTICAL Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gale Stead

  • Optometrist
  • Edina, MN
  • NPI 1578515102
  Authorized official Same address or phone

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1821243239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 GALLERIA",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354218",
            "telephone_number": "952-922-1052",
            "fax_number": "952-922-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 GALLERIA",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354218",
            "telephone_number": "952-922-1052",
            "fax_number": "952-922-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFTH AVENUE OF EDINA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-26",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "STEAD",
        "authorized_official_first_name": "GALE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-922-1052",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1456",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": "1456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FIFTH AVENUE OPTICAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alison Fiala, PA-C
• Craig J Ficks, D.P.M.
• Elsa Victoria Fiebiger, D.O.
• Cali Michelle Fielder, LICSW
• Adam Todd Fieldson
• Mary M Figueroa, MD
• Carol Fillmore, DNP, FNP-BC
• Filmtec Corporation
• Douglas Mark Fincham, HIS
• Joshua Fingerman, PT

• Eyewear Supplier in Edina, MN
• Providers in Edina, MN by specialty
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.