Jayden2006

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

JAYDEN2006

Doing business as

Pearle Vision Coon Rapids

Practice address

13195 Weaver Lake Rd
Maple Grove, MN 55369-9410

Phone

(612) 599-0153

NPI assigned

Feb 13, 2013

Organization subpart

No

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

Authorized official

Name

Mr. James Hawley

Title

President

Phone

(612) 599-0153

Specialties & licenses 1

Addresses

Other names 1

• Pearle Vision Coon Rapids Doing business as

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1922347848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12256 LAKEVIEW DRIVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "612-599-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 WEAVER LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553699410",
            "telephone_number": "612-599-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYDEN2006",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-13",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "HAWLEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-599-0153",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision Coon Rapids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Marie Janssen
• David Doyle Jantzi, PT, DPT, ATC, CSCS
• Pamela January
• Sara Colleen Jardine, P.T.
• Suzanne G Jasberg, MD
• Alexandra Jean, M.H.SC., (C) CCC-SLP
• Cydney Jean, DC
• Kevin Christopher Jean, DC
• Kamrun Jenabzadeh, M.D.
• Jon Norman Jensen, PH.D.

• Optician in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Optician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.