THE OPTICAL SHOP INC. (NPI# 1063588374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063588374 |
| Entity Type | Organization |
| Organization Name | THE OPTICAL SHOP INC. |
| Practice Address |
112 22nd Ave S Brookings SD 57006-2600 |
| Practice Telephone | 6056925173 |
| Practice Fax Number | 6056926710 |
| Mailing Telephone | 6056925173 |
| Mailing Fax Number | 6056926710 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. TOM ANDERSON (OWNER) |
| Authorized Official Telephone | 6056925173 |
| Authorized Official Credential | A.B.O.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
05001=========ES | SD | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 9280970 | 05 |
| Street Address |
112 22ND AVE S |
| City | BROOKINGS |
| State | SD |
| Zip Code | 57006-2600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316119738 | Pietz-coats Optometry Inc | Optometrist | 112 22nd Ave S, Brookings, SD 57006-2600 | 2008-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720685845 | Leah Kroeger | Specialist/Technologist | 2820 Stanley J Marshall Center, Brookings, SD 57006 | 2020-10-01 |
| 1619454774 | Alec Edward Weis | Student in an Organized Health Care Education/Training Program | 314 Main Ave Apt 4., Brookings, SD 57006 | 2018-07-22 |
| 1629569066 | Robin Lynn Erz | Counselor | East Central Behavioral Health, 211 4th Street, Brookings, SD 57006 | 2018-05-22 |
| 1982057246 | City of Brookings | Clinic/Center | 310 22nd Avenue, Brookings, SD 57006 | 2016-07-21 |
| 1922413806 | Avera Mckennan | Clinic/Center | 400 2nd Ave, Brookings, SD 57006 | 2014-06-30 |
| 1093157554 | Nathan William Hilbrands | Dentist | 427 8th St S, Brookings, SD 57006 | 2013-07-25 |
| 1992073951 | Andrea Uckert | Counselor | 619 5th Ave Ste 3, Brookings, SD 57006 | 2011-12-06 |
| 1972800100 | Melissa Ann Klemm | Counselor | 1304 Main Ave S, Brookings, SD 57006 | 2011-02-24 |
| 1285873539 | Amy Lynn Osterberg | Counselor | 211 4th St., East Central Mh/cd Center Inc, Brookings, SD 57006 | 2009-02-10 |
| 1114062072 | Kendalls Rexall Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 223 6th St, Brookings, SD 57006 | 2007-02-20 |
| Find all providers in zip 57006 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801972054 | Wal-mart Stores, Inc. | Technician/Technologist | 2233 6th St, Brookings, SD 57006-1731 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164911400 | J & J Optical | Technician/Technologist | 2120 Lazelle St, Sturgis, SD 57785-1316 | 2018-05-02 |
| 1568879419 | Wal-mart Stores, Inc. | Technician/Technologist | 5200 W 60th Street N, Sioux Falls, SD 57107-6504 | 2014-07-11 |
| 1700136041 | W-j Optical | Technician/Technologist | 2101 Broadway Ave, Yankton, SD 57078-1607 | 2012-09-13 |
| 1205184249 | Wal-mart Stores Inc | Technician/Technologist | 100 E Stumer Rd, Rapid City, SD 57701-6417 | 2012-08-23 |
| 1063769388 | Amj Enterprises | Technician/Technologist | 4426 S Technology Dr, Suite E, Sioux Falls, SD 57106-4203 | 2012-08-06 |
| 1437415148 | Carla J Mcgregor | Technician/Technologist | 916 9th Ave Se, Watertown, SD 57201-5224 | 2012-04-06 |
| 1194029041 | Sams West Inc | Technician/Technologist | 1020 N Lacrosse St, Rapid City, SD 57701 | 2011-01-07 |
| 1043482300 | Kathryn A Thomas | Technician/Technologist | 211 E Havens Ave, Mitchell, SD 57301-4402 | 2008-03-27 |
| 1841324027 | Donald George Woeltge | Technician/Technologist | 2118 N Maple Ave, Rapid City, SD 57701-7813 | 2007-03-16 |
| 1518035187 | Jubal S Pillen | Technician/Technologist | 1020 Junction Ave, Sturgis, SD 57785-1632 | 2006-12-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.