LUMEN VISION PC (NPI# 1447879663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447879663 |
| Entity Type | Organization |
| Organization Name | LUMEN VISION PC |
| Practice Address |
5120 Prosperity Way S Ste 114 Fargo ND 58104-7568 |
| Mailing Address |
6844 17th St S Fargo ND 58104-7857 |
| Practice Telephone | 7014049096 |
| Mailing Telephone | 7014049096 |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |
| Authorized Official Name | RYAN THOMAS CAPOUCH (FOUNDER/CEO) |
| Authorized Official Telephone | 7014049096 |
| 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 |
5120 PROSPERITY WAY S STE 114 |
| City | FARGO |
| State | ND |
| Zip Code | 58104-7568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1720447808 | Eyes On Broadway LLC | Optometrist | 311 Broadway N, Fargo, ND 58102-4714 | 2016-02-17 |
| 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.