NPIMap

Organization Active NPI

Clarkson Optometry Inc

Doing business as Clarkson Eyecare

  • Optometrist
  • Elk River, MN
National Provider Identifier
1952992976
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CLARKSON OPTOMETRY INC
Doing business as
Clarkson Eyecare
Practice address
510 Freeport Ave NW Ste C
Elk River, MN 55330-3007
Phone
(763) 441-3431
NPI assigned
Feb 2, 2021
Last updated
Feb 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Authorized official

Name
James WachterNPI 1689670697
Title
Cmo
Phone
(636) 200-4393

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

510 Freeport Ave NW Ste C
Elk River, MN 55330-3007

Mailing address

PO Box 207158
Dallas, TX 75320-7158
Phone (636) 200-4393

Other names 1

  • Clarkson Eyecare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231229000911 MN DME Supplier - Physician - Optometrist 0840411799 Practice locations: Elk River, MN

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Clarkson Optometry Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

510 Freeport Ave NW
Elk River, MN 55330

9721 Lyndale Ave S
Minneapolis, MN 55420
Phone (952) 884-8338

28 Arnold Mall
Arnold, MO 63010
Phone (314) 432-6137

1028 Town and Country Crossing Dr
Chesterfield, MO 63017
Phone (636) 230-9190

1729 Clarkson Rd
Chesterfield, MO 63017
Phone (636) 733-0090

100 Brickton Rd
Ste 102
Columbia, MO 65201
Phone (573) 303-3937

1020 E Green Meadows Rd
Ste 100
Columbia, MO 65201
Phone (573) 303-3960

230 N Lindbergh Blvd
Florissant, MO 63031
Phone (314) 921-9377

3533 Dunn Rd
Florissant, MO 63033
Phone (314) 838-2100

6313 Ronald Reagan Dr
Lake St Louis, MO 63367
Phone (636) 561-2342

330 W Osage St
Pacific, MO 63069
Phone (636) 271-4500

11941 Manchester Rd
Saint Louis, MO 63131
Phone (314) 501-8300

2185 S Mason Rd
Saint Louis, MO 63131
Phone (314) 389-2020

4305 Butler Hill Rd
Saint Louis, MO 63128
Phone (314) 487-4744

6415 Chippewa St
Saint Louis, MO 63109
Phone (314) 457-1880

7 N Euclid Ave
Saint Louis, MO 63108
Phone (314) 884-2382

1595 Denmark Rd
Union, MO 63084
Phone (636) 584-8989

1595 Denmark Rd
Ste 3
Union, MO 63084
Phone (636) 584-8989

514 Warren County Ctr
Warrenton, MO 63383
Phone (636) 377-2054

1894 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 887-4000

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 80

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.

View all 80

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1952992976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207158",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207158",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 FREEPORT AVE NW STE C",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553303007",
            "telephone_number": "763-441-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSON OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarkson Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.