Organization Active NPI

David S Cook O.D. P.C.

Doing business as Family Eye Care Associates

  • Optometrist
  • Cadillac, MI
National Provider Identifier
1417900077
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003808 Issued in MI
Legal business name
DAVID S COOK O.D. P.C.
Doing business as
Family Eye Care Associates
Practice address
8809 Pine Ridge Dr
Cadillac, MI 49601-1289
Phone
(231) 775-3755
Fax
(231) 775-1710
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Authorized official

Name
Dr. David S Cook, O.D.NPI 1780753749
Title
President/Owner
Phone
(231) 775-3755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901003808 MI Primary

Addresses

Primary practice location

8809 Pine Ridge Dr
Cadillac, MI 49601-1289

Mailing address

8809 Pine Ridge Dr
Cadillac, MI 49601-1289
Phone (231) 775-3755

Other identifiers 2

IdentifierTypeStateIssuer
944610320MedicaidMI
900H310350OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • FAMILY EYE CARE ASSOCIATES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050322000479 MI Part B Supplier - Clinic/Group Practice 3779538848 Receives reassigned benefits from 2 practitioners
Practice locations: Cadillac, MI
O20100930069561 MI DME Supplier - Physician - Optometrist 3779538848 Practice locations: Cadillac, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2097248Family Eye Care Associates8809 Pine Ridge Drive, Cadillac, MI 49601Certificate of waiverOct 24, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
David S Cook O.D. P.C.8809 Pine Ridge Dr, Cadillac, MI 49601-7064(231) 775-3755 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Apr 1, 2005

National Provider Directory

National Provider Directory

Locations

919 N Mitchell St
Cadillac, MI 49601
Phone (231) 775-3755

Interoperability endpoints

  • Direct secure messaging: drcook@cadillacfamilyeyecare.eyefinity-direct.com
  • Direct secure messaging: dscook@cadillacfamilyeyecare.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1417900077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8809 PINE RIDGE DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496011289",
            "telephone_number": "231-775-3755",
            "fax_number": "231-775-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8809 PINE RIDGE DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496011289",
            "telephone_number": "231-775-3755",
            "fax_number": "231-775-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID S COOK O.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "231-775-3755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944610320",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900H310350",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY EYE CARE ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cadillac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.