NPIMap

Organization Active NPI

Eye & ENT Specialists

  • Eyewear Supplier
  • Hastings, MI
National Provider Identifier
1194936740
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYE & ENT SPECIALISTS
Practice address
1761 W M 43 Hwy
Hastings, MI 49058-8378
Phone
(269) 945-3888
Fax
(269) 945-2112
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Dr. Kimberly J Norris, MD
Title
Owner
Phone
(269) 945-3888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1761 W M 43 Hwy
Hastings, MI 49058-8378

Mailing address

1761 W M 43 Hwy
Hastings, MI 49058-8378
Phone (269) 945-3888

Other identifiers 1

IdentifierTypeStateIssuer
864135064MedicaidMI

Other names 1

  • Creekside Optical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eye ENT Specialists3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2309/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1194936740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 W M 43 HWY",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490588378",
            "telephone_number": "269-945-3888",
            "fax_number": "269-945-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 W M 43 HWY",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490588378",
            "telephone_number": "269-945-3888",
            "fax_number": "269-945-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE & ENT SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-945-3888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "864135064",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creekside Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hastings, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; 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.