Organization Active NPI

Northern Eye Care Associates, P.C.

  • Optometrist
  • Iron Mountain, MI
National Provider Identifier
1548455231
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002661 Issued in MI
Legal business name
NORTHERN EYE CARE ASSOCIATES, P.C.
Practice address
200 Fairbanks St
Iron Mountain, MI 49801-1510
Phone
(906) 774-8280
Fax
(906) 774-8290
NPI assigned
Sep 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
David Dale Siegler, O.D.
Title
Optometrist
Phone
(906) 774-8280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901002661 MI Primary

Addresses

Primary practice location

200 Fairbanks St
Iron Mountain, MI 49801-1510

Mailing address

200 Fairbanks St
Iron Mountain, MI 49801-1510
Phone (906) 774-8280

Other identifiers 1

IdentifierTypeStateIssuer
0B26508OtherMIBCBSM

National Provider Directory

National Provider Directory

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": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1548455231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FAIRBANKS ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498011510",
            "telephone_number": "906-774-8280",
            "fax_number": "906-774-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FAIRBANKS ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498011510",
            "telephone_number": "906-774-8280",
            "fax_number": "906-774-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN EYE CARE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "SIEGLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "906-774-8280",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0B26508",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.