NPIMap

Organization Active NPI

Creekside Vision & Hearing, PLC

  • Specialist
  • Hastings, MI
National Provider Identifier
1508829573
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CREEKSIDE VISION & HEARING, PLC
Practice address
1761 W M-43 Hwy
Suite 1
Hastings, MI 49058-8378
Phone
(269) 945-3888
Fax
(269) 945-2112
NPI assigned
Apr 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Authorized official

Name
Kimberly J Norris, MDNPI 1659335305
Title
Owner/Opthalmologist
Phone
(269) 945-3888

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1761 W M-43 Hwy
Suite 1
Hastings, MI 49058-8378

Mailing address

1761 W M-43 Hwy
Suite 1
Hastings, MI 49058-8378
Phone (269) 945-3888

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041213000547 MI Part B Supplier - Clinic/Group Practice 1355308263 Receives reassigned benefits from 3 practitioners
Practice locations: Hastings, MI
O20100930029124 MI DME Supplier - Physician - Optometrist 1355308263 Practice locations: Hastings, MI

National Provider Directory

National Provider Directory
Tax ID family
Eye ENT Specialists3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481241600000",
    "number": "1508829573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 W M-43 HWY",
            "address_2": "SUITE 1",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490588378",
            "telephone_number": "269-945-3888",
            "fax_number": "269-945-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 W M-43 HWY",
            "address_2": "SUITE 1",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490588378",
            "telephone_number": "269-945-3888",
            "fax_number": "269-945-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE VISION & HEARING, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2016-12-09",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/OPTHALMOLOGIST",
        "authorized_official_telephone_number": "269-945-3888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.