Charlevoix Eye Center, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004725 Issued in MI

Legal business name

CHARLEVOIX EYE CENTER, P.C.

Practice address

1008 Bridge St
Charlevoix, MI 49720-1602

Phone

(231) 547-7800

NPI assigned

Jun 8, 2013

Last updated

Aug 16, 2013By 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. Jon Vanwagnen, O.D.NPI 1376808071

Title

Optometrist

Phone

(989) 916-6168

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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.

• Jon Christopher Vanwagnen, O.D.

  • Optometrist
  • Alpena, MI
  • NPI 1376808071
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1370649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376611200000",
    "number": "1619315926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 BRIDGE ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 BRIDGE ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201602",
            "telephone_number": "231-547-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLEVOIX EYE CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-08",
        "last_updated": "2013-08-16",
        "status": "A",
        "authorized_official_last_name": "VANWAGNEN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "989-916-6168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael James Cebulski, CPRC,CADC
• Charlevoix Area Hospital (Charlevoix Surgeons)
• Charlevoix Area Hospital (Charlevoix Area Hospital Midlevel Group)
• Charlevoix Commons Apothecary, LTD (Central Drug Store)
• Charlevoix County Coa
• Charlevoix Family Dentistry PLC
• Charlevoix Nursing Home Corporation (Boulder Park Terrace)
• Charlevoix Physicians Clinic
• Charlevoix Senior Citizens Center, Inc
• Charlevoix-Emmet Intermediate School District

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; 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.