Andover Optical Inc

Primary specialty

Contact Lens FitterTaxonomy code 156FC0801X

Legal business name

ANDOVER OPTICAL INC

Practice address

13855 Round Lake Blvd NW
Andover, MN 55304-3664

Phone

(763) 421-0141

Fax

(763) 421-0334

NPI assigned

Dec 8, 2006

Last updated

Feb 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Laine Sangren

Title

Vice Pres

Phone

(763) 421-0141

Specialties & licenses 3

Addresses

Other identifiers 5

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1972663383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13855 ROUND LAKE BLVD NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043664",
            "telephone_number": "763-421-0141",
            "fax_number": "763-421-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13855 ROUND LAKE BLVD NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043664",
            "telephone_number": "763-421-0141",
            "fax_number": "763-421-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDOVER OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "SANGREN",
        "authorized_official_first_name": "LAINE",
        "authorized_official_title_or_position": "VICE PRES",
        "authorized_official_telephone_number": "763-421-0141",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "156FC0800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10294AN",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2115818",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "747001",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "114915",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "16125",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaley Rae Anderson
• Sarah Sue Anderson, MS/CCC-SLP
• Shelly Renee Anderson, APRN
• Andover Family Chiropractic PA
• Andover Family Dentistry, LLC (Andover Family Dentistry)
• Andrews Chiropractic, P.a.
• Tracy Lynn Andrews, D.C.
• Nkeiruka Sylvia Anyiam
• Steve G. Applebaum, MD
• Arbor Oaks Senior Living

• Technician/Technologist in Andover, MN
• Providers in Andover, MN by specialty
• Technician/Technologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.