SUSAN MARIE MOON (NPI# 1497912174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497912174 |
| Entity Type | Individual |
| Full Name | SUSAN MARIE MOON |
| Other Name | SUSAN MARIE WARD-MOON |
| Credential | O.D. |
| Practice Address |
621 E Lake St Tawas City MI 48763-9213 |
| Mailing Address |
Po Box 231 East Tawas MI 48730-0231 |
| Practice Telephone | 9899840929 |
| Practice Fax Number | 9899840931 |
| Mailing Telephone | 9899840929 |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2009-07-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 4901003215 | MI | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265620454 | Susan Christine Moon | Physical Therapist | 2169 S 77th East Ave, Tulsa, OK 74129-2417 | 2007-10-12 |
| 1538235999 | Susan Norris Moon | Counselor | 500 S Johnson St, Kahoka, MO 63445-1608 | 2006-11-28 |
| 1063011450 | Susan S Moon | Pharmacist | 2728 E Main St, Springfield, OH 45503-5117 | 2020-10-18 |
| 1144317769 | Susan Michele Moon | Counselor | 1481 W 10th St, C1194, Indianapolis, IN 46202-2803 | 2006-10-06 |
| 1982710471 | Susan S Moon | Internal Medicine | 1000 Johnson Ferry Rd, Atlanta, GA 30342-1606 | 2006-08-21 |
| 1598771610 | Susan M. Moon | Family Medicine | 3551 Roger Brooke Dr, San Antonio, TX 78234-6200 | 2006-07-31 |
| Street Address |
621 E LAKE ST |
| City | TAWAS CITY |
| State | MI |
| Zip Code | 48763-9213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457378820 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 621 E Lake St, Tawas City, MI 48763-9213 | 2006-07-16 |
| 1801441126 | Steven Lee Buchman | Pharmacist | 621 E Lake St, Tawas City, MI 48763-9213 | 2019-08-04 |
| 1497107833 | Molly Reynolds | Pharmacist | 621 E Lake St, Tawas City, MI 48763-9213 | 2016-07-11 |
| 1982933586 | Sunrise Vision Care | Optometrist | 621 E Lake St, Tawas City, MI 48763-9213 | 2009-12-10 |
| 1588746499 | Wal-mart Stores East, Lp | Technician/Technologist | 621 E Lake St, Tawas City, MI 48763-9213 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720447006 | Josie Short | Student in an Organized Health Care Education/Training Program | 127 Wheeler Street, Tawas, MI 48763 | 2016-02-16 |
| 1689052698 | Victoria Mcgillis | Nurse Practitioner | 325 E M 55 Ste B, Tawas City, MI 48763 | 2015-05-11 |
| 1942500160 | Jeffrey M Chadwick O D P C | Optometrist | 325 M-55, Tawas City, MI 48763 | 2010-10-22 |
| 1659536068 | Josip Petani | Pediatrics | 101 W. Lake St, Tawas City, MI 48763 | 2008-07-24 |
| 1790963312 | Phillip A Wienczewski Pllc | Dentist | 671 E M 55, Tawas City, MI 48763 | 2008-02-06 |
| 1902090038 | Life Family Chiropractic LLC | Chiropractor | 196 M 55, Life Family Chiropractic, Tawas City, MI 48763 | 2007-08-31 |
| 1467586446 | Thomas Aldrich Dawson | Dentist | 508 Hemlock Avenue, Tawas City, MI 48763 | 2007-03-14 |
| 1497819056 | Phillip Allen Wienczewski | Dentist | 671 E M55, Tawas City, MI 48763 | 2006-12-20 |
| 1821163106 | Charles Edward Kudwa | Dentist | 510 West Lake St, Tawas City, MI 48763 | 2006-11-21 |
| 1720017312 | Jeffrey Michael Chadwick | Optometrist | 325 M-55 East, Tawas City, MI 48763 | 2006-07-03 |
| Find all providers in zip 48763 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942500160 | Jeffrey M Chadwick O D P C | Optometrist | 325 M-55, Tawas City, MI 48763 | 2010-10-22 |
| 1720017312 | Jeffrey Michael Chadwick | Optometrist | 325 M-55 East, Tawas City, MI 48763 | 2006-07-03 |
| 1982933586 | Sunrise Vision Care | Optometrist | 621 E Lake St, Tawas City, MI 48763-9213 | 2009-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154921815 | Daniel & Max, LLC | Optometrist | 5020 Bay Rd, Saginaw, MI 48604-2522 | 2020-10-30 |
| 1689274516 | Soave Eye Care | Optometrist | 522 S Garfield Ave Ste A, Traverse City, MI 49686-3485 | 2020-10-29 |
| 1821697152 | Chelsea Vernaci | Optometrist | 42550 Garfield Rd Ste 101, Clinton Twp, MI 48038-1644 | 2020-10-19 |
| 1225636095 | Crystal Angela Ruemenapp | Optometrist | 1691 E Us 23 Ste 2, East Tawas, MI 48730-9337 | 2020-10-14 |
| 1053926089 | Estefany Colon Lopez | Optometrist | 3497 S Linden Rd Spc 780, Flint, MI 48507-3018 | 2020-09-15 |
| 1770195794 | Caitlin Elise-nosanov Winsor | Optometrist | 1761 W M 43 Hwy Ste 1, Hastings, MI 49058-8567 | 2020-08-20 |
| 1194336446 | Bennett Optometry LLC | Optometrist | 555 E Michigan Ave, Saline, MI 48176-1588 | 2020-08-11 |
| 1538777255 | James Bong-suk Kim | Optometrist | 19747 W 12 Mile Rd Ste L7a, Southfield, MI 48076-2584 | 2020-07-20 |
| 1295352987 | Ashleigh Yates | Optometrist | 3152 Peregrine Dr Ne Ste 205, Grand Rapids, MI 49525-9723 | 2020-06-29 |
| 1467078915 | Jaclyn Tolles | Optometrist | 63 1st St, Milan, MI 48160-1001 | 2020-06-21 |
| Find all providers with the same taxonomy | ||||
| City | TAWAS CITY |
| Zip Code | 48763 |
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| 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.