Organization Active NPI

Family Eye Care of Sandusky, PC

  • Optometrist
  • Sandusky, MI
National Provider Identifier
1164778114
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY EYE CARE OF SANDUSKY, PC
Practice address
454 W Sanilac Rd
Sandusky, MI 48471-1065
Phone
(810) 648-2020
NPI assigned
Jul 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Authorized official

Name
Dr. Jacqueline Scarbrough, ODNPI 1285668863
Title
Optomerist
Phone
(810) 359-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

454 W Sanilac Rd
Sandusky, MI 48471-1065

Mailing address

454 W Sanilac Rd
PO Box 28
Sandusky, MI 48471-1065
Phone (810) 648-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130209000032 MI Part B Supplier - Clinic/Group Practice 0547414021 Receives reassigned benefits from 4 practitioners
Practice locations: Sandusky, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1164778114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 W SANILAC RD",
            "address_2": "PO BOX 28",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711065",
            "telephone_number": "810-648-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 W SANILAC RD",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711065",
            "telephone_number": "810-648-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE OF SANDUSKY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "SCARBROUGH",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OPTOMERIST",
        "authorized_official_telephone_number": "810-359-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.