Individual provider Active NPI

Debra Lin Denton, O.D.

  • Optometrist
  • Petoskey, MI
National Provider Identifier
1124053954
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004055 Issued in MI
Practice address
932 Spring St Ste 101
Petoskey, MI 49770-2286
Phone
(231) 487-5315
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004055 MI Primary

Addresses

Primary practice location

932 Spring St Ste 101
Petoskey, MI 49770-2286

Mailing address

932 Spring St Ste 101
Petoskey, MI 49770-2286
Phone (231) 487-5315

Other identifiers 1

IdentifierTypeStateIssuer
4929006MedicaidMI

Other names 1

  • Dr. Debra Lin Denton-Carlson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060920000073 MI Practitioner - Optometry 0941205231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashley Rossman Eye CareGroup PAC ID 6406180801, 4 clinicians

Practice addresses (Care Compare)

560 W Mitchell St
Suite 204
Petoskey, MI 49770-2276
Phone (231) 487-0171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004055MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ashley Rossman Eye Care Optometrist CurrentSince Mar 1, 2024 Accepting new patients
Timothy S Jarvi MD PC CurrentSince Sep 1, 2006 Accepting new patients
Professional Optical LLC Past Accepting new patients

Locations

932 Spring St
Ste 101
Petoskey, MI 49770
Phone (231) 487-5315

2325 Summit Park Dr
Petoskey, MI 49770
Phone (231) 348-3600

560 W Mitchell St
Ste 204
Petoskey, MI 49770
Phone (231) 487-0171

2325 Summit Park Dr
Ste A
Petoskey, MI 49770
Phone (231) 348-3600

4070 Charlevoix Rd
Petoskey, MI 49770
Phone (231) 487-5315

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1124053954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 SPRING ST STE 101",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702286",
            "telephone_number": "231-487-5315",
            "fax_number": "231-487-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 SPRING ST STE 101",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702286",
            "telephone_number": "231-487-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENTON",
        "first_name": "DEBRA",
        "middle_name": "LIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4929006",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "DENTON-CARLSON",
            "middle_name": "LIN",
            "prefix": "DR.",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.