Active NPI
Madison Vision Clinic
- Optometrist
- Madison, SD
National Provider Identifier
1861531642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 126
- Legal business name
- MADISON VISION CLINIC
- Practice address
- 411 SE 10TH St
Madison, SD 57042-3567 - Phone
- (605) 256-2324
- Fax
- (605) 256-3597
- NPI assigned
- Feb 6, 2007
- Last updated
- Aug 7, 2009
- Organization subpart
- Yes
- Parent organization
- JUDSON J BERGAN
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Judson Jay Bergan, O.D.
- Title
- Owner
- Phone
- (605) 256-2324
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 126 | SD | Primary |
Addresses
Primary practice location
411 SE 10TH St
Madison, SD 57042-3567
Mailing address
PO Box 58
Madison, SD 57042-0058
Phone (605) 256-2324
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0070052 | Other | SD | WELLMARK BLUE CROSS & BLUE SHIELD |
| 9201230 | Medicaid | SD |
National Provider Directory
National Provider Directory- Part of
- Madison Vision Clinic
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Optometrist
- Madison, SD
- NPI 1710976378
-
- Optometrist
- Madison, SD
- NPI 1104055904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1249603200000",
"number": "1861531642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 58",
"city": "MADISON",
"state": "SD",
"postal_code": "570420058",
"telephone_number": "605-256-2324",
"fax_number": "605-256-3597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 SE 10TH ST",
"city": "MADISON",
"state": "SD",
"postal_code": "570423567",
"telephone_number": "605-256-2324",
"fax_number": "605-256-3597"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MADISON VISION CLINIC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "JUDSON J BERGAN",
"enumeration_date": "2007-02-06",
"last_updated": "2009-08-07",
"status": "A",
"authorized_official_last_name": "BERGAN",
"authorized_official_first_name": "JUDSON",
"authorized_official_middle_name": "JAY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "605-256-2324",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SD",
"license": "126",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BLUE CROSS & BLUE SHIELD",
"identifier": "0070052",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9201230",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, SD
- Madison Community Hospital (Madison Regional Health System)
- Madison Community Hospital (d/b/a Madison Regional Health System)
- Madison Family Dental
- Madison Family Dental Prof LLC
- Madison Physical Therapy
- Madison Vision Clinic, Inc.
- Angela Meinen, LPC, QMHP
- Andrew Menigoz, DPT
- Kirsti Hasleton Meyer
- Michael S Brooke (Eyecare Center of Madison)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.