Active NPI
Minnesota Eyecare Network, Inc.
Doing business as Neitzke Eye Clinic
- Eyewear Supplier
- Wadena, MN
National Provider Identifier
1932327202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- MINNESOTA EYECARE NETWORK, INC.
- Doing business as
- Neitzke Eye Clinic
- Practice address
- 315 Jefferson St S
Wadena, MN 56482-1533 - Phone
- (218) 631-1456
- Fax
- (218) 631-3213
- NPI assigned
- Apr 23, 2007
- Last updated
- Jul 21, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Timothy C Neitzke, OD
- Title
- President
- Phone
- (218) 631-1456
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | MN | Primary |
Addresses
Primary practice location
315 Jefferson St S
Wadena, MN 56482-1533
Mailing address
315 Jefferson St S
PO Box 146
Wadena, MN 56482-1533
Phone (218) 631-1456
Other names 1
- Neitzke Eye Clinic
National Provider Directory
National Provider Directory- Tax ID family
- Minnesota Eyecare Network I
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Pelican Rapids Eye Clinic
- Eyewear Supplier
- Pelican Rapids, MN
- NPI 1770701047
Locations
315 Jefferson St S
Wadena, MN 56482
Phone (218) 631-1456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1932327202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 JEFFERSON ST S",
"address_2": "PO BOX 146",
"city": "WADENA",
"state": "MN",
"postal_code": "564821533",
"telephone_number": "218-631-1456",
"fax_number": "218-631-3213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 JEFFERSON ST S",
"city": "WADENA",
"state": "MN",
"postal_code": "564821533",
"telephone_number": "218-631-1456",
"fax_number": "218-631-3213"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINNESOTA EYECARE NETWORK, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-23",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "NEITZKE",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "218-631-1456",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Neitzke Eye Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wadena, MN
- Julie Marie Meyer, M.D.
- Midwest Vision Centers Inc (Midwest Vision Centers)
- Joseph Alan Miller, OD
- Megan Miller, PHARMD
- Minnesota Eyecare Network, Inc. (Azure Vision Care)
- Minnesota Specialty Health Systems-Wadena
- Miracle Care
- Miracle Care (Miracle Care Hospice & Palliative Care)
- Miracle Care Dmepos (Miracle Care Services)
- Miracle Care Staffing, LLC (Miracle Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.