Traverse City Eye Consultants P C

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

TRAVERSE CITY EYE CONSULTANTS P C

Practice address

5199 N Royal Dr
Traverse City, MI 49684-9201

Phone

(231) 935-8101

Fax

(231) 935-0955

NPI assigned

Dec 15, 2006

Last updated

Mar 30, 2021By 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

Kenneth B Gum, M.D.

Title

Doctor

Phone

(231) 935-8101

Specialties & licenses 3

Addresses

Locations

Interoperability endpoints

• Direct secure messaging: cburrill@tce.intellechartdirect.net
• Direct secure messaging: katleahy@tce.intellechartdirect.net
• Direct secure messaging: rbeaulieu@tce.intellechartdirect.net
• Direct secure messaging: rfoote@tce.intellechartdirect.net
• Direct secure messaging: rmelstrom@tce.intellechartdirect.net
• Direct secure messaging: skorson@tce.intellechartdirect.net

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Traverse City Eye Consultants P C

  • Ophthalmology Physician
  • Kalkaska, MI
  • NPI 1861554636
  NPPES parent name

Practitioners 5

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.

• Robert Allan Beaulieu, MD

  • Ophthalmology Physician
  • Royal Oak, MI
  • NPI 1750700746
  NPD
• Claire Burrill, OD

  • Optometrist
  • Traverse City, MI
  • NPI 1457174740
  NPD
• Shannon Korson, NP

  • Nurse Practitioner
  • Suttons Bay, MI
  • NPI 1437816006
  NPD
• Kathleen Marie Leahy, OD

  • Optometrist
  • Kalkaska, MI
  • NPI 1104483437
  NPD
• Richard Thomas Melstrom, OD

  • Optometrist
  • Cadillac, MI
  • NPI 1679559322
  NPD

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1316009368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5199 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849201",
            "telephone_number": "231-935-8101",
            "fax_number": "231-935-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5199 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849201",
            "telephone_number": "231-935-8101",
            "fax_number": "231-935-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVERSE CITY EYE CONSULTANTS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "GUM",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "231-935-8101",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Traverse Bay Hospitalists, PLLC
• Traverse Bay Internal Medicine PC
• Traverse Bay Medical
• Traverse Bay Radiation Oncologists
• Traverse City Chiropractic Life Center, Inc
• Traverse City Medical LLC
• Traverse City Opco Group, LLC (Medilodge of Traverse City)
• Traverse City Opco, LLC (The Villa at Traverse Point)
• Traverse City Ophthalmology PLLC (Traverse City Eye)
• Traverse City Orthopedics Physical Therapy PC

• Ophthalmology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.