Active NPI
P-Cor, LLC
Doing business as Advanced Eye Care Clinic
- Optometrist
- Southfield, MI
National Provider Identifier
1154954741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- P-COR, LLC
- Doing business as
- Advanced Eye Care Clinic
- Practice address
- 29350 Southfield Rd Ste 150
Southfield, MI 48076-2011 - Phone
- (248) 647-9790
- NPI assigned
- Feb 21, 2020
- Last updated
- Feb 21, 2020
- 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
- Shakia Tisdale
- Title
- Credentialing/Privileging
- Phone
- (248) 577-3659
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
29350 Southfield Rd Ste 150
Southfield, MI 48076-2011
Mailing address
735 John R Rd Ste 150
Troy, MI 48083-5859
Phone (248) 588-9300
Other names 1
- Advanced Eye Care Clinic
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| P-Cor LLC | Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Pcor-LLC
Other organizations with this tax ID 25
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Commerce Township, MI
- NPI 1821481078
-
- Optometrist
- Monroe, MI
- NPI 1871788562
-
- Optometrist
- Detroit, MI
- NPI 1922428887
-
- Optometrist
- Chesterfield, MI
- NPI 1598179301
Locations
29350 Southfield Rd
Ste 150
Southfield, MI 48076
Phone (248) 647-9790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1582243200000",
"number": "1154954741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "735 JOHN R RD STE 150",
"city": "TROY",
"state": "MI",
"postal_code": "480835859",
"telephone_number": "248-588-9300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29350 SOUTHFIELD RD STE 150",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762011",
"telephone_number": "248-647-9790"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "P-COR, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-02-21",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A",
"authorized_official_last_name": "TISDALE",
"authorized_official_first_name": "SHAKIA",
"authorized_official_title_or_position": "CREDENTIALING/PRIVILEGING",
"authorized_official_telephone_number": "248-577-3659"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Advanced Eye Care Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.