Organization Active NPI

MD Bartley Opticians

  • Eyewear Supplier
  • Brookings, SD
National Provider Identifier
1891828794
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
9280210 Issued in SD
Legal business name
MD BARTLEY OPTICIANS
Practice address
2311 Yorkshire Dr
Brookings, SD 57006-2446
Phone
(605) 692-7619
Fax
(605) 697-9005
NPI assigned
Mar 13, 2007
Last updated
Jan 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Authorized official

Name
Mr. Michael Don BartleyNPI 1972760205
Title
Owner
Phone
(605) 692-7619

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)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 9280210 SD Primary

Addresses

Primary practice location

2311 Yorkshire Dr
Brookings, SD 57006-2446

Mailing address

2311 Yorkshire Dr
Brookings, SD 57006-2446
Phone (605) 692-7619

Other identifiers 1

IdentifierTypeStateIssuer
9290210MedicaidSD

National Provider Directory

National Provider Directory

Locations

2204 Derdall Dr
Brookings, SD 57006
Phone (605) 692-7448

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1891828794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 YORKSHIRE DR",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062446",
            "telephone_number": "605-692-7619",
            "fax_number": "605-697-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 YORKSHIRE DR",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062446",
            "telephone_number": "605-692-7619",
            "fax_number": "605-697-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD BARTLEY OPTICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "BARTLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-692-7619",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "SD",
            "license": "9280210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9290210",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.