NPIMap

Organization Active NPI

Family Vision Care PLLC

  • Optometrist
  • Traverse City, MI
National Provider Identifier
1205081080
Registry record updated Nov 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004141 Issued in MI
Legal business name
FAMILY VISION CARE PLLC
Practice address
2640 Crossing Cir
Traverse City, MI 49684-7930
Phone
(231) 933-7195
Fax
(231) 933-7197
NPI assigned
Nov 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2009

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

Authorized official

Name
Dr. Roseanna Marie David, O.D.
Title
President
Phone
(231) 933-7195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901004141 MI Primary

Addresses

Primary practice location

2640 Crossing Cir
Traverse City, MI 49684-7930

Mailing address

2640 Crossing Cir
Traverse City, MI 49684-7930
Phone (231) 933-7195

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1205081080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 CROSSING CIR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847930",
            "telephone_number": "231-933-7195",
            "fax_number": "231-933-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 CROSSING CIR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847930",
            "telephone_number": "231-933-7195",
            "fax_number": "231-933-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY VISION CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "ROSEANNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-933-7195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.