Active NPI
Randa Jean Wik
- Optician
- Fergus Falls, MN
National Provider Identifier
1982932646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 166965
- Practice address
- 615 S Mill St
Suite 2
Fergus Falls, MN 56537-2756 - Phone
- (218) 998-2020
- Fax
- (218) 998-2098
- NPI assigned
- Nov 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 166965 | MN | Primary |
Addresses
Primary practice location
615 S Mill St
Suite 2
Fergus Falls, MN 56537-2756
Mailing address
16888 River Oaks Blvd
Fergus Falls, MN 56537-7629
Phone (218) 739-2979
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166965 | MN | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 20-20 Optical Inc | Optician | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258502400000",
"number": "1982932646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16888 RIVER OAKS BLVD",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565377629",
"telephone_number": "218-739-2979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S MILL ST",
"address_2": "SUITE 2",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565372756",
"telephone_number": "218-998-2020",
"fax_number": "218-998-2098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIK",
"first_name": "RANDA",
"middle_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-18",
"last_updated": "2009-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "MN",
"license": "166965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fergus Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.