Terris Fashion Optical LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1 Issued in MI

Legal business name

TERRIS FASHION OPTICAL LLC

Practice address

629 W Cloverland Drive
Suite 7
Ironwood, MI 49938-2045

Phone

(906) 932-0020

Fax

(906) 932-8057

NPI assigned

Feb 23, 2007

Last updated

Jul 21, 2022By 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

Mrs. Terri A Kimball

Title

Owner Optician

Phone

(906) 932-0020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669507935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 W CLOVERLAND DRIVE",
            "address_2": "SUITE 7",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "499382045",
            "telephone_number": "906-932-0020",
            "fax_number": "906-932-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 W CLOVERLAND DRIVE",
            "address_2": "SUITE 7",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "499382045",
            "telephone_number": "906-932-0020",
            "fax_number": "906-932-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRIS FASHION OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER OPTICIAN",
        "authorized_official_telephone_number": "906-932-0020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": "1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38723900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Ironwood, MI
• Providers in Ironwood, MI by specialty
• Eyewear Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.