Organization Active NPI

Tudhope Optical Company

  • Eyewear Supplier
  • Port Huron, MI
National Provider Identifier
1083743116
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
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

Updated by the provider on Nov 9, 2011

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)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 4901001807 MI
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
0G40268OtherMIBCBS OF MI VISION PROV.
71062OtherMIHEALTH PLAN OF MICHIGAN

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.