EYES ON BROADWAY LLC (NPI# 1720447808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720447808 |
| Entity Type | Organization |
| Organization Name | EYES ON BROADWAY LLC |
| Practice Address |
311 Broadway N Fargo ND 58102-4714 |
| Practice Telephone | 7013563937 |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |
| Authorized Official Name | MARK TUFTE (OPTOMETRY) |
| Authorized Official Telephone | 7013563937 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| Street Address |
311 BROADWAY N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-4714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538650726 | Ryan Capouch | Optometrist | 311 Broadway N, Fargo, ND 58102-4714 | 2018-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447879663 | Lumen Vision PC | Optometrist | 5120 Prosperity Way S Ste 114, Fargo, ND 58104-7568 | 2020-04-09 |
| 1376194472 | Vanessa Manlove | Optometrist | 1902 25th Ave S, Fargo, ND 58103-5128 | 2019-09-20 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1386028777 | Carissa Guler | Optometrist | 3902 13th Ave S Ste 256, Fargo, ND 58103-3357 | 2015-07-15 |
| 1306139266 | Stacey Archibald | Optometrist | 3409 45th St S Ste 100, Fargo, ND 58104-8970 | 2011-05-25 |
| 1407187065 | Selina Bjorlie | Optometrist | 2826 Lilac Ln N, Fargo, ND 58102-1703 | 2010-01-21 |
| 1073840336 | Kristin F Engstrom, O.d. PC | Optometrist | 3757 55th Ave S, Fargo, ND 58104 | 2009-11-06 |
| 1679808752 | Erin L Barrett | Optometrist | 3265 45th St S Ste 104, Fargo, ND 58104-7930 | 2009-10-07 |
| 1235326398 | Dr. L.r. Masciarelli & Associates Optometry | Optometrist | 4302 13th Ave S, Fargo, ND 58103-3395 | 2007-10-02 |
| 1427174267 | Michele M Erickson | Optometrist | 1401 33rd St S, Fargo, ND 58103-3429 | 2007-03-22 |
| Find all providers in FARGO | ||||
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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.