Dr. Courtney Ray Sivertson
Optometrist Optomitrist - Corneal and Contact Lenses
3632 10th Ln Nw
Rochester
, Minnesota 55901-7032
Dr. Courtney Ray Sivertson
Optometrist Optomitrist - Corneal and Contact Lenses
3632 10th Ln Nw
Rochester
, Minnesota 55901-7032
(507) 210-4894
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About
Features
Specialties
- Optometrist
- Optomitrist - Corneal and Contact Lenses
Languages spoken
- English
Location
First Address
- Dr. Courtney Ray Sivertson
- 3632 10th Ln Nw
- Rochester, MN
- Zip : 55901-7032
- Phone : (507) 210-4894
Second Address
- Dr. Courtney Ray Sivertson
- 3632 10th Ln Nw
- Rochester, MN
- Zip : 55901-7032
- Phone : (507) 282-7121
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3070 | MN |
| N | 152W00000X | Optometrist | 6246453-9934 | UT |
| N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 3070 | MN |
National Provider Identifier
| NPI | 1114948734 |
|---|---|
| Provider Name | Dr. Courtney Ray Sivertson |
| First Address | Rochester, MN 55901-7032 |
| Second Address | Rochester, MN 55901-7032 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/07/2006 |
| Last Update Date | 19/07/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 09Y96LI | BLUE CROSS BLUE SHIELD (01) | MN |
| 09Y98SI | BLUE CROSS BLUE SHIELD (01) | MN |
| 09Y99LI | BLUE CROSS BLUE SHIELD (01) | MN |
| 138801 | UCARE (01) | MN |
| 39797WE | BLUE CROSS BLUE SHIELD (01) | MN |
| 411898525 | HUMANA (01) | MN |
| 411898525 | MAYO MANAGEMENT SERVICES (01) | MN |
| 617A1SI | BLUE CROSS BLUE SHIELD (01) | MN |
| 628A8SI | BLUE CROSS BLUE SHIELD (01) | MN |
| 6C464AN | BLUE CROSS BLUE SHIELD (01) | MN |
| 763132000 | (05) | MN |
| 916891050630 | PREFERRED ONE (01) | MN |
| HP77005 | HEALTH PARTNERS (01) | MN |
| V11757 | (02) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.