Active NPI
Tudhope Optical Company
- Eyewear Supplier
- Port Huron, MI
National Provider Identifier
1083743116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- TUDHOPE OPTICAL COMPANY
- Practice address
- 2840 Pine Grove Ave
Port Huron, MI 48060-1971 - Phone
- (810) 982-0614
- Fax
- (810) 982-0621
- NPI assigned
- Mar 5, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Susan Mary Wiegand
- Title
- Owner
- Phone
- (810) 982-0614
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901001807 | MI | |
| Optician | 156FX1800X | MI | ||
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
2840 Pine Grove Ave
Port Huron, MI 48060-1971
Mailing address
2840 Pine Grove Ave
Port Huron, MI 48060-1971
Phone (810) 982-0614
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0G40268 | Other | MI | BCBS OF MI VISION PROV. |
| 71062 | Other | MI | HEALTH PLAN OF MICHIGAN |
National Provider Directory
National Provider DirectoryLocations
2840 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 982-0614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320796800000",
"number": "1083743116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2840 PINE GROVE AVE",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480601971",
"telephone_number": "810-982-0614",
"fax_number": "810-982-0621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2840 PINE GROVE AVE",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480601971",
"telephone_number": "810-982-0614",
"fax_number": "810-982-0621"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TUDHOPE OPTICAL COMPANY",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-05",
"last_updated": "2011-11-09",
"status": "A",
"authorized_official_last_name": "WIEGAND",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "MARY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "810-982-0614",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": "MI",
"license": "4901001807",
"primary": false
},
{
"code": "156FX1800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MI VISION PROV.",
"identifier": "0G40268",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN OF MICHIGAN",
"identifier": "71062",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Huron, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.