Cedar Run Eye Center Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

CEDAR RUN EYE CENTER OPTICAL

Practice address

3830 W Front St
Traverse City, MI 49684-8153

Phone

(231) 929-3888

Fax

(231) 929-4365

NPI assigned

Apr 30, 2007

Organization subpart

No

Name

Jennifer Grochowalski

Title

Administration

Phone

(231) 929-3888

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 30, 2009.

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259539200000",
    "number": "1215157367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2335",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496852335",
            "telephone_number": "231-929-3888",
            "fax_number": "231-929-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848153",
            "telephone_number": "231-929-3888",
            "fax_number": "231-929-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR RUN EYE CENTER OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2009-11-30",
        "status": "A",
        "authorized_official_last_name": "GROCHOWALSKI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "231-929-3888"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "180B86357",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "900B863470",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francis K Catino, DDS
• Ashleigh Kay Catton, FNP
• Anne M Cavanagh, M.D.
• Amanda Cavanaugh
• Cedar Run Eye Center
• Cedar Run Eye Center-Beulah Optical
• Cedar Run Eye Center, PLLC
• Rowan Celestino
• Celly Health Medical Group of Northern Michigan PC
• Celly Mobile Dialysis, P.a.

• All providers in Traverse City, MI
• Eyewear Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.