NPIMap

Organization Active NPI

Michael J Bennett

Doing business as Lifetime Eyecare

  • Optometrist
  • Juneau, AK
National Provider Identifier
1053503698
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
273325 Issued in AK
Legal business name
MICHAEL J BENNETT
Doing business as
Lifetime Eyecare
Practice address
9309 Glacier Hwy Ste A103
Juneau, AK 99801-9300
Phone
(907) 789-3175
Fax
(907) 789-1778
NPI assigned
Aug 17, 2007
Last updated
Sep 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Bennett, ODNPI 1558454553
Title
Owner
Phone
(907) 789-3175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 273325 AK Primary

Addresses

Primary practice location

9309 Glacier Hwy Ste A103
Juneau, AK 99801-9300

Mailing address

9309 Glacier Hwy Ste A103
Juneau, AK 99801-9300
Phone (907) 789-3175

Other names 1

  • Lifetime Eyecare Doing business as

National Provider Directory

National Provider Directory

Locations

611 W Willoughby Ave
Juneau, AK 99801
Phone (907) 586-2135

9309 Glacier Hwy
Ste A103
Juneau, AK 99801
Phone (907) 789-3175

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1053503698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9309 GLACIER HWY STE A103",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998019300",
            "telephone_number": "907-789-3175",
            "fax_number": "907-789-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9309 GLACIER HWY STE A103",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998019300",
            "telephone_number": "907-789-3175",
            "fax_number": "907-789-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J BENNETT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-789-3175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "273325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Juneau, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.