P-Cor,LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

P-COR,LLC

Practice address

100 E Michigan Ave Ste 1110
Jackson, MI 49201-1498

Phone

(248) 588-9300

Fax

(248) 588-3355

NPI assigned

Mar 1, 2021

Organization subpart

No

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

Authorized official

Name

Shakia Tisdale

Title

Credentialing & Privileging

Phone

(248) 577-3659

Specialties & licenses 1

Addresses

Other names 1

• HENRY FORD OPTIMEYES Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Henry Ford Health System

  • Optometrist
  • Detroit, MI
  • NPI 1346324688

  Member Of

  NPD member

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1275127342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 JOHN R RD STE 150",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835859",
            "telephone_number": "248-588-9300",
            "fax_number": "248-588-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E MICHIGAN AVE STE 1110",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011498",
            "telephone_number": "248-588-9300",
            "fax_number": "248-588-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P-COR,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "TISDALE",
        "authorized_official_first_name": "SHAKIA",
        "authorized_official_title_or_position": "CREDENTIALING & PRIVILEGING",
        "authorized_official_telephone_number": "248-577-3659"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HENRY FORD OPTIMEYES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Out of the Woods Mental Health LLC
• Britanee Owen
• Nathaniel Owsley, MA
• Emily Oxbrough, LLMSW
• Charles Onyekachi Ozukwe Jr.
• Padbury and Padbury, D.D.S, M.S., P.C.
• Allan Dale Padbury, D.D.S.
• Allan Dale Padbury Jr., D.D.S.
• Branda Elizabeth Page, MS, BSN, RN
• Elisa Page

• Optometrist in Jackson, MI
• Providers in Jackson, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.