NPIMap

Organization Active NPI

Ely Vision - Optometry Center P.C.

Doing business as Ely Vision Center

  • Corneal and Contact Management Optometrist
  • Ely, MN
National Provider Identifier
1992806814
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
2959 Issued in MN
Legal business name
ELY VISION - OPTOMETRY CENTER P.C.
Doing business as
Ely Vision Center
Practice address
38 E Harvey St
Ely, MN 55731-1240
Phone
(218) 365-4919
Fax
(218) 365-7770
NPI assigned
Sep 25, 2006
Last updated
Sep 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Authorized official

Name
Dr. Erin Troy Bremner, O.D.NPI 1124033782
Title
Owner
Phone
(218) 365-4919

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 2959 MN Primary

Addresses

Primary practice location

38 E Harvey St
Ely, MN 55731-1240

Mailing address

38 E Harvey St
Ely, MN 55731-1240
Phone (218) 365-4919

Other names 1

  • Ely Vision Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040716000391 MN Part B Supplier - Clinic/Group Practice 6800875543 Receives reassigned benefits from 1 practitioner
Practice locations: Ely, MN

National Provider Directory

National Provider Directory

Locations

38 E Harvey St
Ely, MN 55731
Phone (218) 365-4919

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253145600000",
    "number": "1992806814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 E HARVEY ST",
            "city": "ELY",
            "state": "MN",
            "postal_code": "557311240",
            "telephone_number": "218-365-4919",
            "fax_number": "218-365-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 E HARVEY ST",
            "city": "ELY",
            "state": "MN",
            "postal_code": "557311240",
            "telephone_number": "218-365-4919",
            "fax_number": "218-365-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELY VISION - OPTOMETRY CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2009-09-17",
        "status": "A",
        "authorized_official_last_name": "BREMNER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-365-4919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MN",
            "license": "2959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ely Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ely, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.