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ROBERT DODGE O.D., NPI 1164424370

Optometrist in COON RAPIDS, MN

Last Updated on : Jul 09,2007

About ROBERT DODGE (NPI 1164424370)


ROBERT DODGE is an Optometrist provider in COON RAPIDS, United States. His medical specialization is Optometrist .

1164424370 is NPI number of ROBERT DODGE.

ROBERT DODGE's primary taxonomy code based on NPI Lookup is 152W00000X with license number 2510. This taxonomy code refers to Optometrist.

ROBERT DODGE has more than 16 years of experience.

ROBERT DODGE current practice location address is PO BOX 48451, COON RAPIDS, MN.

You can also correspond with ROBERT DODGE through mail at mailing address 12737 RIVERDALE BLVD NW, COON RAPIDS, MN, United States. Mailing address contact number is 763-433-3468.

The enumeration date of ROBERT DODGE is 01-Jun-2005. The provider is registered as an Individual and the NPI record was last updated 15 years ago.

1164424370 NPI Information

Name ROBERT DODGE
National Provider Id (NPI) 1164424370
Entity Type Individual
Gender M
Credential O.D.
Practice Address PO BOX 48451,
COON RAPIDS, MN, United States
Practice Telephone
Practice Fax Number
Mailing Address 12737 RIVERDALE BLVD NW ,
COON RAPIDS, MN, United States
Mailing Telephone 763-433-3468
Mailing Fax Number
Enumeration Date 01-Jun-2005
Last Updated Date 09-Jul-2007

ROBERT DODGE (NPI 1164424370) Primary Taxonomy Information

Primary Taxonomy Code Clasification License Number License State
Y 152W00000X Optometrist 2510 MN

Additional Identifiers

Identifier Type/Code Identifier State Identifier Issuer
026765100 MEDICAID (05) MN
41-0000515 MEDICARE ID-Type Unspecified (04)
U51648 MEDICARE UPIN (02)

ROBERT DODGE (NPI 1164424370) Office Location

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1033385398 MICHELLE A GOLLOBIT Occupational Therapist 1138 ORIOLE AVE, PO BOX 173
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1598215394 COON RAPIDS-BAYARD COMMUNITY SCHOOL DISTRICT Local Education Agency (LEA) 905 NORTH ST,
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1922720960 NICHOLE MARIE THOMAS Registered Nurse 316 2ND AVE,
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1437334935 JANELLE ELIZABETH KIDDER Nurse Practitioner, Family 2104 NORTHDALE BLVD NW, SUITE 220
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1902884760 JAYNE CERNOHOUS Dentist, General Practice 8960 SPRINGBROOK DR NW, SUITE 150
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1689335697 KELLY LARSON Behavior Technician 9120 SPRINGBROOK DR NW,
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1245218759 NIHAR S SHAH Radiology, Diagnostic Radiology 2355 HIGHWAY 36 W STE 100,
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1760539746 MICHELLE MANOS Physician Assistant 8462 NORWAY ST NW,
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FAQs

Whose NPI Number is 1164424370?

1164424370 is the NPI number of ROBERT DODGE.

What is the specialty for ROBERT DODGE?

The Specialty of ROBERT DODGE is Optometrist.

NPI number meaning

Field Name Field Value
NPI 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Business Mailing Address The mailing address of the provider being identified contains First line, Second Line, City name, State name, Postal code, and Country code.
Provider Business Mailing Address Telephone Number The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider Business Practice Location Address Telephone Number The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number The fax number associated with the location address of the provider being identified.
Provider Enumeration Date The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date The date that a record was last updated or changed.
Authorized Official Telephone Number The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy Taxonomy Description of the Healthcare Provider.
Provider License Number Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
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