Active NPI
Nathan L. Vetter, OD
- Optometrist
- Fargo, ND
National Provider Identifier
1922064633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2934
- Practice address
- 2101 Elm St N
Fargo, ND 58102-2417 - Phone
- (701) 232-3241
- Fax
- (701) 237-2690
- NPI assigned
- Apr 21, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2897T | OR | |
| Optometrist | 152W00000X | 2934 | MN | Primary |
| Optometrist | 152W00000X | 3807 | WA |
Addresses
Primary practice location
2101 Elm St N
Fargo, ND 58102-2417
Mailing address
2101 Elm St N
Fargo, ND 58102-2417
Phone (701) 232-3241
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130523000314 | ND | Order and Referring Only - Optometry | 3577701036 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2897T | OR | MD | Optometrist |
| 3807 | WA | MD | Optometrist |
| 2934 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1922064633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 ELM ST N",
"city": "FARGO",
"state": "ND",
"postal_code": "581022417",
"telephone_number": "701-232-3241",
"fax_number": "701-237-2690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 ELM ST N",
"city": "FARGO",
"state": "ND",
"postal_code": "581022417",
"telephone_number": "701-232-3241",
"fax_number": "701-237-2690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VETTER",
"first_name": "NATHAN",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "2897T",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "2934",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "3807",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.