Mary Terese Meernik, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002862 Issued in MI

Practice address

872 Munson Ave
Suite B
Traverse City, MI 49686-3638

Phone

(231) 947-1690

Fax

(231) 947-1692

NPI assigned

Feb 6, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1417135922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 MUNSON AVE",
            "address_2": "SUITE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863638",
            "telephone_number": "231-947-1690",
            "fax_number": "231-947-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 MUNSON AVE",
            "address_2": "SUITE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863638",
            "telephone_number": "231-947-1690",
            "fax_number": "231-947-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEERNIK",
        "first_name": "MARY",
        "middle_name": "TERESE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7079623",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Meacham Mead, RN, BSN, LLMSW
• Timothy Michael Meagher, MA, LLP
• Kyle Medearis, MS OTRL
• Margaret J Meeker, M.D.
• Walter K Meeker, M.D.
• Karan D Mehta, MD
• Jayea L Meihls
• Meijer Inc
• Susan Meis, PA-C
• Madison Meister Meister

• 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 Jan 22, 2016; 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.