NPIMap

Organization Active NPI

Clinton Ophthalmology, PC

  • Ophthalmology Physician
  • Saint Johns, MI
National Provider Identifier
1053650473
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
5101016172 Issued in MI
Legal business name
CLINTON OPHTHALMOLOGY, PC
Practice address
1000 E Sturgis St
Suite 3
Saint Johns, MI 48879-2068
Phone
(989) 224-1452
Fax
(989) 224-1453
NPI assigned
Feb 5, 2013
Last updated
Jan 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Authorized official

Name
Brandy Elizabeth Cook, DONPI 1710199450
Title
President/Physician
Phone
(989) 224-1452

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 5101016172 MI Primary

Addresses

Primary practice location

1000 E Sturgis St
Suite 3
Saint Johns, MI 48879-2068

Mailing address

1000 E Sturgis St
Suite 3
Saint Johns, MI 48879-2068
Phone (989) 224-1452

National Provider Directory

National Provider Directory

Locations

1002 N US Highway 27
Saint Johns, MI 48879
Phone (989) 224-1452

Interoperability endpoints

  • Direct secure messaging: bcook@cook.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 1

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": "1360022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1053650473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E STURGIS ST",
            "address_2": "SUITE 3",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488792068",
            "telephone_number": "989-224-1452",
            "fax_number": "989-224-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E STURGIS ST",
            "address_2": "SUITE 3",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488792068",
            "telephone_number": "989-224-1452",
            "fax_number": "989-224-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON OPHTHALMOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-05",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "989-224-1452",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "5101016172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.