Cedar Run Eye Center

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CEDAR RUN EYE CENTER

Practice address

3830 W Front St
Traverse City, MI 49684-8153

Phone

(231) 929-3888

Fax

(231) 929-4365

NPI assigned

May 1, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Grochowalski

Title

Administration

Phone

(231) 929-3888

Specialties & licenses 1

Addresses

Tax ID family

Cedar Run Eye Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cedar Run Eye Center-Beulah Optical

  • Eyewear Supplier
  • Traverse City, MI
  • NPI 1942420096
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jodi Marie Hummel, OD

  • Optometrist
  • Traverse City, MI
  • NPI 1497736102
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265653224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• Optometrist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.