Dr. Glen D Nydam, O.D.
Dr. Glen D Nydam is a Optometrist provider (Optometrist) practicing in Mitchell, SD, registered in the NPPES registry with NPI 1003887688 since 2006. The credential OD stands for Doctor of Optometry.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1003887688 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Dr. Glen D Nydam |
| Credential | O.D. |
| Sex | Male |
| Practice address | 305 N SANBORN BLVD, Mitchell, SD, 57301 |
| Phone | 6059962537 |
| Fax | 6059960500 |
| Enumeration date | 2006-01-31 |
| Last updated in NPPES | 2022-11-10 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 152W00000X | Optometrist | Primary | 542 | SD |
OD — Doctor of Optometry: A licensed optometrist providing primary vision care, eye exams, and corrective lenses. About the OD credential
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20048 | Other | SD | SANFORD HEALTH PLAN |
| 9170527 | Other | SD | DAKOTACARE |
| 9203192 | Medicaid | SD | — |
| 0006936 | Other | SD | WELLMARK BCBS |
| 230048 | Other | SD | MIDLANDS CHOICE |
| 9203190 | Medicaid | SD | — |
Copy-ready billing details
Provider: Glen Nydam, O.D. NPI: 1003887688 Taxonomy: 152W00000X (Optometrist) Address: 305 N SANBORN BLVD, Mitchell, SD, 57301
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1174594741 | Ray Birkenkamp | Individual | Ophthalmology Physician | Mitchell, SD |
| 1942271382 | Gregg Bleeker | Individual | Optometrist | Mitchell, SD |
| 1922053933 | Mabee Clinic Ltd | Organization | Ophthalmology Physician | Mitchell, SD |
| 1578519864 | Mabee Eye Clinic PC | Organization | Optometrist | Mitchell, SD |
| 1568653426 | Deborah Bessler | Individual | Optometrist | Mitchell, SD |
| 1932576410 | Nicholas Wenande | Individual | Optometrist | Mitchell, SD |
| 1134656937 | Drs Liudahl & Bleeker PC | Organization | Optometrist | Mitchell, SD |
Verify this record
Cross-check NPI 1003887688 against the authoritative CMS record: view Dr. Glen D Nydam on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How do I verify Glen Nydam's NPI record?
Is NPI 1003887688 active?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2022-11-10.