CEDAR RUN EYE CENTER OPTICAL (NPI# 1215157367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215157367 |
| Entity Type | Organization |
| Organization Name | CEDAR RUN EYE CENTER OPTICAL |
| Practice Address |
3830 W Front St Traverse City MI 49684-8153 |
| Mailing Address |
Po Box 2335 Traverse City MI 49685-2335 |
| Practice Telephone | 2319293888 |
| Practice Fax Number | 2319294365 |
| Mailing Telephone | 2319293888 |
| Mailing Fax Number | 2319294365 |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2009-11-30 |
| Authorized Official Name | JENNIFER GROCHOWALSKI (ADMINISTRATION) |
| Authorized Official Telephone | 2319293888 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 180B86357 | 01 |
| MI | BCBSM | 900B863470 | 01 |
| Street Address |
3830 W FRONT ST |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-8153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851383129 | Bradley S Hochstetler | Ophthalmology | 3830 W Front St, Traverse City, MI 49684-8153 | 2005-08-22 |
| 1366651572 | Robert F Stevenson | Ophthalmology | 3830 W Front St, Traverse City, MI 49684-8153 | 2007-05-22 |
| 1265653224 | Cedar Run Eye Center | Optometrist | 3830 W Front St, Traverse City, MI 49684-8153 | 2007-05-01 |
| 1942420096 | Cedar Run Eye Center-beulah Optical | Eyewear Supplier (Equipment, not the service) | 3830 W Front St, Traverse City, MI 49684-8153 | 2007-04-30 |
| 1518029909 | Cedar Run Eye Center, Pllc | Durable Medical Equipment & Medical Supplies | 3830 W Front St, Traverse City, MI 49684-8153 | 2006-12-14 |
| 1134235252 | Linda Jean Madigan | Nurse Anesthetist, Certified Registered | 3830 W Front St, Traverse City, MI 49684-8153 | 2006-08-22 |
| 1497736102 | Jodi Marie Hummel | Optometrist | 3830 W Front St, Traverse City, MI 49684-8153 | 2005-11-09 |
| 1144214180 | Timothy B. Hanley | Ophthalmology | 3830 W Front St, Traverse City, MI 49684-8153 | 2005-09-06 |
| 1134113517 | Kathryn A Cizek | Optometrist | 3830 W Front St, Cedar Run Eye Center, Traverse City, MI 49684-8153 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851754881 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 2668 Crossing Cir, Traverse City, MI 49684-6105 | 2016-03-29 |
| 1366780348 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 1545 S Division St, Ste. 122, Traverse City, MI 49684-4056 | 2013-01-25 |
| 1245421544 | Essilor Laboratories of America, Inc | Eyewear Supplier (Equipment, not the service) | 2323 W Aero Park Ct, Traverse City, MI 49686-9102 | 2007-08-05 |
| 1568596898 | Craftsmen Optical In. | Eyewear Supplier (Equipment, not the service) | 1077 W South Airport Rd, Traverse City, MI 49686-4737 | 2007-03-16 |
| 1073659124 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 3200 S Airport Rd W Ste 232, Traverse City, MI 49684-7865 | 2007-01-29 |
| 1194816900 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 1212 S Airporte Hwy, Cherryland Mall, Traverse City, MI 49686-4759 | 2006-09-27 |
| 1679558712 | Nichols Optical Inc | Eyewear Supplier (Equipment, not the service) | 336 W Front St, Traverse City, MI 49684-2204 | 2005-12-13 |
| 1497264667 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 125 E South Airport Rd, Traverse City, MI 49686 | 2017-09-20 |
| 1942420096 | Cedar Run Eye Center-beulah Optical | Eyewear Supplier (Equipment, not the service) | 3830 W Front St, Traverse City, MI 49684-8153 | 2007-04-30 |
| 1316009368 | Traverse City Eye Consultants P C | Eyewear Supplier (Equipment, not the service) | 5199 N Royal Dr, Traverse City, MI 49684-9201 | 2006-12-15 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
Please comment or provide details below to improve the information on CEDAR RUN EYE CENTER OPTICAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.