MICHAEL A CANDREVA (NPI# 1346388915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346388915 |
| Entity Type | Individual |
| Full Name | MICHAEL A CANDREVA |
| Credential | OD |
| Practice Address |
10 N River Road Fort Yates ND 58538 |
| Mailing Address |
N 10 River Road Fort Yates ND 58538 |
| Practice Telephone | 7018548248 |
| Practice Fax Number | 7018547411 |
| Mailing Telephone | 7018548248 |
| Mailing Fax Number | 7018547411 |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2018-08-17 |
| NPI Deactivation Date | 07/17/2007 |
| NPI Reactivation Date | 2007-08-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | CO1796 | CO | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 5540010 | 05 |
| Street Address |
10 N RIVER ROAD |
| City | FORT YATES |
| State | ND |
| Zip Code | 58538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801381355 | Xtal Silk | Licensed Practical Nurse | 10 N River Road, Fort Yates, ND 58538 | 2018-06-27 |
| 1861943979 | Kelsey Mauch | Pharmacist | 10 N River Road, Fort Yates, ND 58538 | 2016-10-24 |
| 1467820118 | Kimberly Hawk Eagle | Licensed Practical Nurse | 10 N River Road, Fort Yates, ND 58538 | 2015-09-11 |
| 1144604158 | Brittany Azure Bearstail | Family Medicine | 10 N River Road, Fort Yates, ND 58537 | 2015-07-20 |
| 1386057800 | Abby Davis | Family Medicine | 10 N River Road, Fort Yates, ND 58538 | 2014-06-03 |
| 1861831877 | Christine E Rosheim | Nurse Practitioner | 10 N River Road, Fort Yates, ND 58538 | 2013-06-24 |
| 1235485426 | Amber Tincher | Family Medicine | 10 N River Road, Fort Yates, ND 58538 | 2012-07-25 |
| 1588826648 | Darian Richard Schaubert | Dietitian, Registered | 10 N River Road, Fort Yates, ND 58538 | 2008-06-30 |
| 1861557977 | Penny Marie Wilkie | Family Medicine | 10 N River Road, Fort Yates, ND 58538 | 2006-12-27 |
| 1114085727 | Callie C Baker | Registered Nurse | 10 N River Road, Fort Yates, ND 58538 | 2006-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922650753 | Kelly Reiner | Psychologist | 10 S River Rd, Fort Yates, ND 58538 | 2019-07-11 |
| 1003367665 | Sara Froelich | Licensed Practical Nurse | N 10 River Rd, Fort Yates, ND 58538 | 2016-10-19 |
| 1649694928 | Charles Swenson | Hearing Instrument Specialist | 9266 Highway 24, Fort Yates, ND 58538 | 2014-02-07 |
| 1093142416 | Jennifer Dawn Campbell | Registered Nurse | 10 N. River Road, Fort Yates, ND 58538 | 2013-09-30 |
| 1861827743 | Standing Rock Sioux Tribe | Family Medicine | 139 Proposal Ave, Standing Rock Sioux Tribe, Fort Yates, ND 58538 | 2013-09-10 |
| 1184990608 | Standing Rock Early Childhood Tracking Program | Physical Therapist | 001 Standing Rock Avenue, Ft. Yates, ND 58538 | 2012-03-29 |
| 1699046706 | Sarah Rippley | Emergency Medical Technician, Paramedic | 143 Proposal Avenue, Fort Yates, ND 58538 | 2012-01-20 |
| 1972731974 | Standing Rock Public Transportation | Secured Medical Transport (VAN) | 1341 92nd Street, Fort Yates, ND 58538 | 2009-06-29 |
| 1144430679 | Christine Grace Peterson | Dentist | Standing Rock Ihs Hospital, 00n10 North River Road, Fort Yates, ND 58538 | 2007-05-23 |
| 1528289881 | Mark Jackson | Preventive Medicine | 10 Standing Rock Agency Avenue, Fort Yates, ND 58538 | 2007-05-02 |
| Find all providers in zip 58538 | ||||
| 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 |
|---|---|---|---|---|
| 1558972349 | Minnesota Optometric Eye Doctor, P.a. | Optometrist | 2650 32nd Ave S # Setf3, Grand Forks, ND 58201-6541 | 2020-08-14 |
| 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 |
| 1720632094 | Kaylin Elizabeth Krein | Optometrist | 404- Hwy 2 East, Devils Lake, ND 58301-0130 | 2019-07-25 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1235794140 | Joseph S Klabo | Optometrist | 201 7th St Sw Ste 2, Rugby, ND 58368-2100 | 2019-05-06 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1760964795 | Focus Eye Care Prof LLC | Optometrist | 16 W Divide Street, Bowman, ND 58623 | 2018-09-06 |
| 1871031153 | West Fargo Eyecare Associates PC | Optometrist | 3139 Bluestem Dr, Ste 112, West Fargo, ND 58078-8089 | 2017-02-07 |
| 1720447808 | Eyes On Broadway LLC | Optometrist | 311 Broadway N, Fargo, ND 58102-4714 | 2016-02-17 |
| Find all providers with the same taxonomy | ||||
| City | FORT YATES |
| Zip Code | 58538 |
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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.