Edward P. Kosanke, Optometrist P.C

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002498 Issued in MI

Legal business name

EDWARD P. KOSANKE, OPTOMETRIST P.C

Practice address

730 S Main St
Cheboygan, MI 49721-2220

Phone

(231) 627-5666

NPI assigned

Aug 13, 2007

Last updated

Sep 10, 2010By 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

Dr. Edward Paul Kosanke, O.D.NPI 1568459659

Title

President

Phone

(231) 627-5666

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, and the practitioner matching its NPPES authorized official.

• Edward Paul Kosanke, O.D.

  • Optometrist
  • Cheboygan, MI
  • NPI 1568459659
  Authorized official Same address or phone

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284076800000",
    "number": "1457543555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 S MAIN ST",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212220",
            "telephone_number": "231-627-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 S MAIN ST",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212220",
            "telephone_number": "231-627-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD P. KOSANKE, OPTOMETRIST P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2010-09-10",
        "status": "A",
        "authorized_official_last_name": "KOSANKE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-627-5666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945103234",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.