Professional Family Eyecare Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003333 Issued in MI

Legal business name

PROFESSIONAL FAMILY EYECARE INC.

Practice address

28825 Ryan Rd
Warren, MI 48092-4128

Phone

(586) 573-0470

Fax

(586) 573-0648

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Christopher David Theodoroff, O.D.

Title

Optometrist

Phone

(586) 573-0470

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Ann Wong, OD

  • Low Vision Rehabilitation Optometrist
  • Warren, MI
  • NPI 1346303856
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1295896900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28825 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924128",
            "telephone_number": "586-573-0470",
            "fax_number": "586-573-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28825 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924128",
            "telephone_number": "586-573-0470",
            "fax_number": "586-573-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL FAMILY EYECARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "THEODOROFF",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "586-573-0470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MICHIGAN",
            "identifier": "900E066750",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priority One Hospice Care Inc
• Leann Emily Pritchard-Hryshko, LLMSW
• Pro Dental Mi 1 PC
• Problem Solved Counseling Service LLC
• Professional Dental Alliance of Michigan,LLC
• Professional Periodontics
• Professional PT and Rehab PC
• Professional Rehab & Pain Management PC
• Progressive Podiatry PLC
• Progressive Rehab Network LTD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.