NORTHWEST EYE CLINIC, P.A. (NPI# 1073699823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073699823 |
| Entity Type | Organization |
| Organization Name | NORTHWEST EYE CLINIC, P.A. |
| Practice Address |
21395 John Milless Dr Rogers MN 55374-4402 |
| Mailing Address |
8401 Golden Valley Rd Suite 330 Golden Valley MN 55427-4486 |
| Practice Telephone | 7634167600 |
| Practice Fax Number | 7634285047 |
| Mailing Telephone | 7633834130 |
| Mailing Fax Number | 7633834147 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2009-08-25 |
| Authorized Official Name | AUDREY IRENE BERG (BUSINESS OFFICE SUPERVISOR) |
| Authorized Official Telephone | 7633834140 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 360 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346326196 | Northwest Eye Clinic, P.a. | Ophthalmology | 5657 Duluth St, Golden Valley, MN 55422-4054 | 2006-10-27 |
| 1700962552 | Northwest Eye Clinic, P.a. | Ophthalmology | 2805 Campus Dr, Suite 105, Plymouth, MN 55441-2676 | 2006-10-27 |
| 1801972658 | Northwest Eye Clinic, P.a. | Ophthalmology | 3366 Oakdale Ave N, Suite 402, Robbinsdale, MN 55422-2948 | 2006-10-27 |
| Street Address |
21395 JOHN MILLESS DR |
| City | ROGERS |
| State | MN |
| Zip Code | 55374-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609872522 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 21395 John Milless Dr, Rogers, MN 55374-4402 | 2005-06-24 |
| 1083075865 | Katelyn O'keefe | Occupational Therapist | 21395 John Milless Dr, Suite 600, Rogers, MN 55374 | 2016-03-08 |
| 1497124929 | Ariel Schibilla | Family Medicine | 21395 John Milless Dr, Rogers, MN 55374-4402 | 2015-09-15 |
| 1184069304 | Kristina Kay Thissen | Physician Assistant | 21395 John Milless Dr, Rogers, MN 55374-4402 | 2013-05-01 |
| 1891934188 | Jeffrey Kent Sletten | Physical Therapist | 21395 John Milless Dr, Suite 600, Rogers, MN 55374-4402 | 2009-02-11 |
| 1558443168 | Distinctive Eyewear | Technician/Technologist | 21395 John Milless Dr, Suite 200, Rogers, MN 55374-4402 | 2006-10-20 |
| 1598712820 | Chandra Shirley | Physical Therapist | 21395 John Milless Dr, Suite 600, Rogers, MN 55374-4402 | 2006-05-30 |
| 1447229786 | David Allen Everson | Physical Therapist | 21395 John Milless Dr, Rogers, MN 55374-4402 | 2006-03-17 |
| 1912975954 | Ann M Murphy | Physical Therapist | 21395 John Milless Dr, Suite 600, Rogers, MN 55374-4402 | 2006-03-08 |
| 1205802576 | Luann K Lerud | Physical Therapist | 21395 John Milless Dr, Rogers, MN 55374-4406 | 2006-02-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609335835 | Rebecca Loehrer | Nurse Practitioner | 21370 Ste 210 John Milless Dr., Rogers, MN 55374 | 2019-03-18 |
| 1255722328 | Samantha Colai | Marriage & Family Therapist | 21307 John Milless Drive, Suite 106, Rogers, MN 55374 | 2015-02-11 |
| 1437559648 | Jamie Mosley | Counselor | 2100 Rogers Drive, Suite 200, Rogers, MN 55374 | 2014-08-26 |
| 1295145886 | Marisa Kolasa | Massage Therapist | 22290 Oakdale Drive, Rogers, MN 55374 | 2014-05-05 |
| 1871878165 | Derek P Doty Dc Inc | Chiropractor | 21410 136th Ave N, Suite 105a, Rogers, MN 55374 | 2011-10-18 |
| 1912205865 | Michelle Cheryl Finnegan-larson | Registered Nurse | 21308 John Milless Drive, Rogers, MN 55374 | 2011-03-02 |
| 1639402571 | Ascend Family Institute | Community/Behavioral Health | 20980 Rogers Drive, #400, Rogers, MN 55374 | 2009-09-10 |
| 1275738403 | Nicole M Clements | Physician Assistant | 1355 Rogers Drive, Rogers, MN 55374 | 2007-06-18 |
| 1558566166 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 21455 John Milless Drive, Rogers, MN 55374 | 2007-06-15 |
| 1811062854 | Randall Alvin Hohbein | Pharmacist | 21351 John Milless Drive, Rogers Drug, Rogers, MN 55374 | 2006-11-22 |
| Find all providers in zip 55374 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508028218 | Daniel Thomas Sines | Ophthalmology | 3737 W Walnut St, Rogers, AR 72756-1839 | 2008-06-25 |
| 1609840693 | Randall E Cole | Ophthalmology | 3737 W. Walnut, Rogers, AR 72757-1353 | 2006-02-15 |
| 1427022532 | Charles William Hof | Ophthalmology | 3737 W. Walnut, P.o. 1353, Rogers, AR 72756-1353 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290486 | Eye Care Associates, Pa | Ophthalmology | 710 E 24th St Ste 101-201, Minneapolis, MN 55404-3840 | 2018-10-12 |
| 1548794316 | Trevor Kindle | Ophthalmology | 200 1st Ave Nw, Rochester, MN 55901 | 2017-04-18 |
| 1790228294 | Eye Associates of Central Minnesota Pa | Ophthalmology | 628 Roosevelt Rd, Suite 101, Saint Cloud, MN 56301-4867 | 2016-12-01 |
| 1093160491 | Christina Gillmor | Ophthalmology | 516 Delaware St Se Fl 9, Minneapolis, MN 55455-0356 | 2016-05-04 |
| 1861889776 | Michael Andrew Jordan | Ophthalmology | 825 Nicollet Mall Ste 2000, Minneapolis, MN 55402-2708 | 2015-04-17 |
| 1467872390 | Luke Dolezal | Ophthalmology | 5851 Duluth St Ste 215, Golden Valley, MN 55422-3956 | 2014-04-17 |
| 1811330939 | James Layer | Ophthalmology | 3708 Upton Ave S, Minneapolis, MN 55410-1237 | 2013-04-08 |
| 1093058158 | Hao Tang | Ophthalmology | 7760 France Ave S Ste 310, Edina, MN 55435 | 2013-03-27 |
| 1407112881 | Phillip Michael Armand Radke | Ophthalmology | 7450 France Ave S Ste 100, Edina, MN 55435-4799 | 2012-04-10 |
| 1023374964 | Sasha Strul | Ophthalmology | 701 25th Ave S Ste 300, Minneapolis, MN 55454-1443 | 2012-04-04 |
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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.