DR. GREGORY M MACIK (NPI# 1922004514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922004514 |
| Entity Type | Individual |
| Full Name | DR. GREGORY M MACIK |
| Credential | OD |
| Practice Address |
101 Willmar Ave Sw Affiliated Community Medical Centers Willmar MN 56201 |
| Practice Telephone | 3202315000 |
| Practice Fax Number | 2202315067 |
| Mailing Telephone | 3202315000 |
| Mailing Fax Number | 2202315067 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2008-12-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | MN2973 | MN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | COLE MANAGED VISION CARE | 222010 | 01 |
| MN | EYEMED VISION CARE | MN2973 | 01 |
| MN | MEDICA/UNITED HEALTH CARE | 22-02526 | 01 |
| MN | 650127300 | 05 | |
| MN | AMERICA'S PPO | 2237465 | 01 |
| MN | BCBS | 339M8MA | 01 |
| Street Address |
101 WILLMAR AVE SW AFFILIATED COMMUNITY MEDICAL CENTERS |
| City | WILLMAR |
| State | MN |
| Zip Code | 56201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356956601 | Crystal Lynn Fleischhacker | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-09-14 |
| 1730798760 | Katherine Anderson | Pharmacist | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-07-27 |
| 1861015786 | Madalyn Marie Vohnoutka | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-05-27 |
| 1811526403 | Meagan A Hoflock | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-04-06 |
| 1124657150 | Carris Health LLC | Clinic/Center | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-04-02 |
| 1689209900 | Sophie Sharon Reecher | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-03-06 |
| 1285267922 | Kavitha Malango | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-02-21 |
| 1972147858 | Jamie Kalean Erickson | Pharmacist | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-11-04 |
| 1124660865 | Carris Health LLC | Durable Medical Equipment & Medical Supplies | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-10-15 |
| 1891355913 | Stephanie Jo Johanneck | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-06-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730793472 | Sarah Erickson | Counselor | 2120 60th Ave N.w., Willmar, MN 56201 | 2020-09-01 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1154856524 | Mude Transportation Inc | Non-emergency Medical Transport (VAN) | 1712 Monongalia Ave Sw Ap1, Willmar, MN 56201 | 2017-04-24 |
| 1285025874 | Jill Fellows | Occupational Therapist | 611 5th St. Sw, Willmar, MN 56201 | 2015-02-18 |
| 1700294881 | Brenda Wiese | Counselor | 1617 Hwy 12 E, Suite 230, Willmar, MN 56201 | 2014-08-01 |
| 1275955932 | Courtney Regnier | Marriage & Family Therapist | 2320 E Hwy 12 Ste 2, Willmar, MN 56201 | 2014-01-15 |
| 1568732402 | Pamela Jean Kubesh | Social Worker | 328 Sw 3rd Street, Willmar, MN 56201 | 2012-01-10 |
| 1699931824 | Community Behavioral Health Hospital-willmar | Psychiatric Hospital | 1208 Olena Ave Se, Willmar, MN 56201 | 2008-08-07 |
| 1700053345 | Nathan Schrick | Marriage & Family Therapist | 513 Sw 5th Street, Box 1810, Willmar, MN 56201 | 2008-05-13 |
| 1831381680 | Joan M Blonigan Christianson | Chiropractor | 1101 S 1st Street, Willmar, MN 56201 | 2007-08-15 |
| Find all providers in zip 56201 | ||||
| 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 |
|---|---|---|---|---|
| 1679727697 | Stephen J. Reigstad Optometry Inc. | Optometrist | 330 4th St Sw, Willmar, MN 56201-3332 | 2008-11-05 |
| 1912018128 | Sam William Skoviera | Optometrist | 1605 So 1st St, Midwest Vision Center, Willmar, MN 56201 | 2006-08-31 |
| 1649215476 | Bradley L Backhaus | Optometrist | 2404 1st St S, Suite 1, Willmar, MN 56201-6300 | 2006-06-17 |
| 1073004289 | Whitney Stock | Optometrist | 1801 19th Ave Sw, Willmar, MN 56201-4946 | 2018-05-23 |
| 1386081065 | Jennifer Lynn Fairbanks | Optometrist | 1801 19th Ave Sw, Willmar, MN 56201 | 2013-06-04 |
| 1881031524 | Jared Jay Fairbanks | Optometrist | 1605 1st St S, Willmar, MN 56201-4234 | 2013-06-03 |
| 1366752248 | Shane Jahraus | Optometrist | 1801 19th Ave Sw, Willmar, MN 56201-4946 | 2010-10-13 |
| 1912061458 | Jonathan Larson | Optometrist | 1605 1st St S, Willmar, MN 56201-4234 | 2006-12-20 |
| 1447280847 | Jessica A Wentzell | Optometrist | 101 Willmar Ave Sw, Affiliated Community Medical Centers, Willmar, MN 56201 | 2006-07-03 |
| 1285602888 | Thomas C Mueller | Optometrist | 101 Willmar Ave Sw, Willmar, MN 56201 | 2006-03-09 |
| Find all providers in WILLMAR | ||||
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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.