Northside Optometric Practice P C

Primary specialty

OptometristTaxonomy code 152W00000X

License

L951178 Issued in MI

Legal business name

NORTHSIDE OPTOMETRIC PRACTICE P C

Practice address

100 North Ave
Battle Creek, MI 49017-3417

Phone

(269) 288-8400

Fax

(269) 963-9202

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Duane Dotson, O.D.

Title

Owner

Phone

(269) 288-8400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265655120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTH AVE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173417",
            "telephone_number": "269-288-8400",
            "fax_number": "269-963-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTH AVE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173417",
            "telephone_number": "269-288-8400",
            "fax_number": "269-963-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE OPTOMETRIC PRACTICE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOTSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-288-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "L951178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Battle Creek, MI
• Providers in Battle Creek, 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.