Organization Active NPI

Jeff Hayden Vision Care Center Inc

  • Optometrist
  • Brighton, MI
National Provider Identifier
1245676485
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003926 Issued in MI
Legal business name
JEFF HAYDEN VISION CARE CENTER INC
Practice address
420 E Grand River Ave
Brighton, MI 48116-1516
Phone
(810) 227-2004
Fax
(810) 227-9910
NPI assigned
May 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Cyndi Urbancic
Title
Manager
Phone
(810) 227-2004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901003926 MI Primary

Addresses

Primary practice location

420 E Grand River Ave
Brighton, MI 48116-1516

Mailing address

420 E Grand River Ave
Brighton, MI 48116-1516
Phone (810) 227-2004

Other names 1

  • cook & hayden llc Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130606000102 MI Part B Supplier - Clinic/Group Practice 5698910362 Receives reassigned benefits from 2 practitioners
Practice locations: Brighton, MI

National Provider Directory

National Provider Directory

Locations

420 E Grand River Ave
Brighton, MI 48116
Phone (810) 227-2004

Practitioners & affiliated clinicians

Practitioners 2

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": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1245676485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E GRAND RIVER AVE",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161516",
            "telephone_number": "810-227-2004",
            "fax_number": "810-227-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E GRAND RIVER AVE",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161516",
            "telephone_number": "810-227-2004",
            "fax_number": "810-227-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF HAYDEN VISION CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "URBANCIC",
        "authorized_official_first_name": "CYNDI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "810-227-2004"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "cook & hayden llc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.