CHARLES LANNOM (OD) – Optometrist, NPI 1205823648

CHARLES LANNOM (OD) is a healthcare provider. based in Eden prairie, Minnesota. specializing in Optometrist. They hold the professional credentials OD. They hold a License No. 1825 (MN). The NPI Number for CHARLES LANNOM (OD) is 1205823648

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
CHARLES LANNOM (OD)
NPI
1205823648
Phone
(952) 934-6926
Address
16550 W 78TH ST
Enumeration Date
30 September 2005
Last Update Date
1 July 2024

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
9529346926
Graduation Year
1980 (46 years ago)
PAC ID
2264441005
Group Practice PAC ID
2466461207
Professional Enrollment ID
I20100325001095
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for CHARLES LANNOM (OD)

  • West 78th Street, Eden Prairie, Hennepin County, Minnesota, 55344, United States

    SUITE A

    EDEN PRAIRIE, MN 553464315

    Phone: (952) 934-6926

    Fax: (952) 934-3402

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55346)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466461207View full group profile
NameSpecialtyState
O P T O M E T R YMN
O P T O M E T R YMN
O P T O M E T R YMN

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Frequently asked questions

What federal number belongs to CHARLES LANNOM (OD)?
The federal identifier for CHARLES LANNOM (OD) is NPI 1205823648.
Is CHARLES LANNOM (OD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize CHARLES LANNOM (OD)'s specialty in plain language?
Clinically, the directory lists CHARLES LANNOM (OD) with Optometrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for CHARLES LANNOM (OD)?
The page summarizes Eden Prairie, Minnesota for CHARLES LANNOM (OD); expand the address list for detail.
Is CHARLES LANNOM (OD) a real provider?
This page reflects official NPPES data for NPI 1205823648. Always confirm identity and privileges with the practice and licensing boards.

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