GREGORY CLARK, O.D., INC.
NPI 1801965504
Optometrist in Coon Rapids, MN
NPI Status: Active since November 07, 2006
Contact Information
12547 RIVERDALE BLVD NW
COSTCO OPTICAL DEPARTMENT
COON RAPIDS, MN
ZIP 55448
Phone: (763) 712-7761
Fax: (763) 712-7787
- Organization
- Optometrist
- Accepts Insurance
About GREGORY CLARK, O.D., INC.
This page provides the complete NPI Profile along with additional information for Gregory Clark, O.d., Inc., a provider established in Coon Rapids, Minnesota operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1801965504 assigned on November 2006. The practitioner's primary taxonomy code is 152W00000X with license number 2806 (MN). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Gregory Alexander Clark O.d. (Owner)
- NPI
- 1801965504
- Provider Name
- GREGORY CLARK, O.D., INC.
- Entity Type
- Organization
- Location Address
- 12547 RIVERDALE BLVD NW COSTCO OPTICAL DEPARTMENT COON RAPIDS, MN 55448
- Location Phone
- (763) 712-7761
- Location Fax
- (763) 712-7787
- Mailing Address
- 16160 22ND PL N PLYMOUTH, MN 55447
- Mailing Phone
- (612) 703-0298
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-07-2006
- Last Update Date
- 11-29-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 2806
- License State
- MN
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Max 70/50 $6700 - PPO
- Blue Max 90/70 $1500 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $3300 - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - PPO
- Blue Max Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3200 - PPO
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
- BlueSelect Silver Standard without Kid's Dental - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| U86742 | MEDICARE UPIN (02) | MN | |
| 1634747-00 | MEDICAID (05) | MN | |
| 410001679 | MEDICARE PIN (08) | MN |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 0 | 1 | 9 | 6 | 5 | 5 | 0 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 0 | 1 | 18 | 6 | 10 | 5 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 0 + 1 + 1 + 8 + 6 + 1 + 0 + 5 + 0 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1801965504 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1114971272 | DR. STEVEN J BRUIN PHARMD Individual | Pharmacist | 12547 RIVERDALE BLVD NW COON RAPIDS, MN 55448 (763) 712-7762 |
| 1770866865 | DR. SPRING LORRAINE ROMER PHARM D Individual | Pharmacist | 12547 RIVERDALE BLVD NW COON RAPIDS, MN 55448 (763) 712-7762 |
| 1467521153 | DR. GREGORY ALEXANDER CLARK O.D. Individual | Optometrist | 12547 RIVERDALE BLVD NW COSTCO OPTICAL DEPARTMENT COON RAPIDS, MN 55448 (763) 712-7761 |
| 1962897819 | COSTCO WHOLESALE CORPORATION Organization | Hearing Aid Equipment | 12547 RIVERDALE BLVD NW COON RAPIDS, MN 55448 (763) 712-7806 |
| 1568572188 | COSTCO WHOLESALE CORPORATION Organization | Pharmacy (Community/Retail Pharmacy) | 12547 RIVERDALE BLVD NW COON RAPIDS, MN 55448 (763) 712-7762 |
| 1326439167 | COSTCO WHOLESALE CORPORATION Organization | Eyewear Supplier | 12547 RIVERDALE BLVD NW COON RAPIDS, MN 55448 (763) 712-7763 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1801965504, enumerated in the NPI registry as an "organization" on November 07, 2006
The provider is located at 12547 Riverdale Blvd Nw Costco Optical Department Coon Rapids, Mn 55448 and the phone number is (763) 712-7761
This medical organization specializes in Optometrist with taxonomy code 152W00000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana, Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on November 07, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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