JAYDEN2006 (NPI# 1922347848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922347848 |
| Entity Type | Organization |
| Organization Name | JAYDEN2006 |
| Other Organization Name | PEARLE VISION COON RAPIDS |
| Practice Address |
13195 Weaver Lake Rd Maple Grove MN 55369-9410 |
| Mailing Address |
12256 Lakeview Drive N Maple Grove MN 55369 |
| Practice Telephone | 6125990153 |
| Mailing Telephone | 6125990153 |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2013-02-13 |
| Authorized Official Name | MR. JAMES HAWLEY (PRESIDENT) |
| Authorized Official Telephone | 6125990153 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Pearle Vision Coon Rapids | Doing Business As Name - Organization |
| Street Address |
13195 WEAVER LAKE RD |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-9410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215091749 | Mark Korthals | Optometrist | 13195 Weaver Lake Rd, Maple Grove, MN 55369-9410 | 2006-12-20 |
| 1104391325 | Matthew Thomas Hendricks | Optometrist | 13195 Weaver Lake Rd, Maple Grove, MN 55369 | 2018-10-04 |
| 1548753122 | Samantha Ziegler | Optometrist | 13195 Weaver Lake Rd, Maple Grove, MN 55369-9410 | 2018-06-08 |
| 1760830012 | Rachel Naomi Knutson | Optometrist | 13195 Weaver Lake Rd, Maple Grove, MN 55369 | 2016-05-26 |
| 1659728756 | John Mueller | Optometrist | 13195 Weaver Lake Rd, Maple Grove, MN 55369-9410 | 2016-05-18 |
| 1831453455 | Brandon Bruce Larson | Optometrist | 13195 Weaver Lake Rd, Maple Grove, MN 55369 | 2012-06-28 |
| 1053540690 | Kelly Crenna | Optometrist | 13195 Weaver Lake Rd, Maple Grove, MN 55369-9410 | 2009-07-03 |
| 1346453735 | Brokea Inc. | Optometrist | 13195 Weaver Lake Rd, Maple Grove, MN 55369-9410 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851696496 | America's Best Contacts & Eyeglasses | Technician/Technologist | 11651 Fountains Dr, Ste A-104, Maple Grove, MN 55369-7195 | 2011-01-12 |
| 1043392632 | Distinctive Eyewear, LLC | Technician/Technologist | 12000 Elm Creek Blvd N Ste 100, Maple Grove, MN 55369-7074 | 2006-10-20 |
| 1902988454 | Wal-mart Stores, Inc. | Technician/Technologist | 9451 Dunkirk Ln N, Maple Grove, MN 55311-5447 | 2006-10-20 |
| 1548350788 | Sam's Club Optical | Technician/Technologist | 16701 94th Ave N, Maple Grove, MN 55311-5448 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821558370 | National Vision Inc | Technician/Technologist | 8348 Highway 7, Saint Louis Park, MN 55426-3907 | 2019-03-21 |
| 1861937112 | Personality Eyewear | Technician/Technologist | 8257 Logan Ave N, Brooklyn Park, MN 55444-1545 | 2016-12-22 |
| 1871961185 | Wal-mart Stores, Inc | Technician/Technologist | 3001 E Highway 7, Montevideo, MN 56265-4556 | 2015-09-03 |
| 1215316682 | National Vision, Inc. | Technician/Technologist | 12940 Riverdale Dr Nw, Ste 300, Coon Rapids, MN 55448-8412 | 2015-05-19 |
| 1619354156 | National Vision, Inc. | Technician/Technologist | 1727 Beam Ave, Ste D, Maplewood, MN 55109-1164 | 2015-05-05 |
| 1124437223 | America's Best Contacts & Eyeglasses | Technician/Technologist | 6096 Shingle Creek Pkwy, Brooklyn Center, MN 55430-2316 | 2014-08-04 |
| 1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
| 1851712384 | Marshall Allan Daly | Technician/Technologist | 2484 University Ave W, Saint Paul, MN 55114-1735 | 2013-12-31 |
| 1174966683 | David Yang | Technician/Technologist | 987 Oday St S, Maplewood, MN 55119-5953 | 2013-04-15 |
| 1063760817 | Wal-mart Stores Inc | Technician/Technologist | 1200 Shingle Creek Crossing, Brooklyn Center, MN 55430 | 2012-08-28 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
Please comment or provide details below to improve the information on JAYDEN2006.
| 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.