ALLISON LYNN WIEDEMANN (NPI# 1770674160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770674160 |
| Entity Type | Individual |
| Full Name | ALLISON LYNN WIEDEMANN |
| Credential | OD |
| Practice Address |
570 Northtown Dr Ne Blaine MN 55434-1043 |
| Practice Telephone | 7637844081 |
| Practice Fax Number | 8668222088 |
| Mailing Telephone | 7637844081 |
| Mailing Fax Number | 8668222088 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2013-08-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3164 | MN | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | OPT002322 | GA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MN OPTOMETRY LICENSE | 3164 | 01 |
| GA | STATE LICENSE | OPT002322 | 01 |
| Street Address |
570 NORTHTOWN DR NE |
| City | BLAINE |
| State | MN |
| Zip Code | 55434-1043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780710459 | Michael Joel Johnson | Optometrist | 570 Northtown Dr Ne, Blaine, MN 55434-1043 | 2007-02-26 |
| 1356498075 | Ocularra Holding. Inc | Optometrist | 570 Northtown Dr Ne, Blaine, MN 55434-1043 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1033770714 | Enduring Home Health Care Corp | Home Health | 10812 Fillmore Street, Blaine, MN 55434 | 2019-06-24 |
| 1932762408 | Vital Agency LLC | In Home Supportive Care | 12864 Fillmore Street Ne, Blaine, MN 55434 | 2019-04-19 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1598253445 | Jacob James Apland | Behavioral Analyst | 12401 Oak Park Blvd Ne Apt 316, Blaine, MN 55434 | 2018-04-26 |
| 1962921924 | Mw Minnetonka Operating LLC | Assisted Living Facility | 1005 Paul Parkway Ne, Blaine, MN 55434 | 2017-09-11 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1629591334 | Minnehaha Transportation Inc | Non-emergency Medical Transport (VAN) | 2507 Walnut St, Roseville, MN 55434 | 2017-07-25 |
| 1629590872 | Alexandra Staum Reif | Pediatrics | 11107 Ulysses Street Ne, Suite 100, Blaine, MN 55434 | 2017-07-10 |
| 1962939546 | Nicolette Gengel | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434 | 2017-05-15 |
| Find all providers in zip 55434 | ||||
| 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 |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1225657067 | Viginia Ho | Optometrist | 680 County Road 10 Ne, Blaine, MN 55434-2329 | 2020-04-12 |
| 1972773422 | Professional Vision Care, Pa | Optometrist | 1409 131st Ave Ne, Blaine, MN 55449-4108 | 2008-03-11 |
| 1245365253 | Bf Eye Care Ltd. | Optometrist | 10995 Club West Parkway, Suite 500, Blaine, MN 55449 | 2007-02-22 |
| 1043363401 | Blaine Eye Clinic Optometrists, P.a. | Optometrist | 12170 Aberdeen St Ne, Blaine, MN 55449-4716 | 2007-01-19 |
| 1932257284 | Angela M Musland | Optometrist | 1510 125th Ave Ne, Blaine, MN 55449-4749 | 2007-01-05 |
| 1992886519 | Robert Chous | Optometrist | 125 Northtown Dr Ne, Blaine, MN 55434-1036 | 2006-10-18 |
| 1689785636 | Jean L Layman | Optometrist | 4405 Pheasant Ridge Dr Ne, Blaine, MN 55449-4531 | 2006-08-31 |
| 1295849917 | Chad M. Krietlow | Optometrist | 260 Northtown Dr Ne, Blaine, MN 55434-1037 | 2006-08-19 |
| 1568423937 | Boyce L. Wilf | Optometrist | 232 H St, Blaine, WA 98230-4018 | 2006-03-28 |
| Find all providers in BLAINE | ||||
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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.