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LAKE REGION EYE CENTER NPI 1528066651


NPI Information

NPI: 1528066651
Provider Name: LAKE REGION EYE CENTER
Classification: Optometrist - 152W00000X
Entity Type: Organization

CLIA Number: 24D2037648

Address:
610 30TH AVE W
STE 200
ALEXANDRIA, MN
ZIP 56308
Phone: (320) 763-7055
Get Directions

LAKE REGION EYE CENTER is an optometrist in Alexandria, MN. The provider is 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. LAKE REGION EYE CENTER NPI is 1528066651. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

610 30TH AVE W
STE 200
ALEXANDRIA, MN
ZIP 56308-426
Phone: (320) 763-7055
Fax: (320) 763-2572

The provider's authorized official is David Schneiderhan .
The authorized official title is Owner/optician and has the following contact phone number (320) 763-7055.

The CLIA number assigned to this NPI record is 24D2037648 - other - optometrist office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/12/2005 and was last updated on 4/4/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristMN2707MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1410001100MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA
2410002211MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA
3U37290MEDICARE UPINMINNESOTA
4C03205MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA
5410000963MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA
6914218500MEDICAIDMINNESOTA
7127518600MEDICAIDMINNESOTA
80801280001MEDICARE NSCMINNESOTA
9428670300MEDICAIDMINNESOTA
10410003486MEDICARE PINMINNESOTA
11597816500MEDICAIDMINNESOTA
12355300134MEDICAIDMINNESOTA
13U73157MEDICARE UPINMINNESOTA
14U98495MEDICARE UPINMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.