Dr Teresa Ennis-Decker & Associates

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003316 Issued in MI

Legal business name

DR TERESA ENNIS-DECKER & ASSOCIATES

Practice address

4313 Corunna Rd
Flint, MI 48532-4152

Phone

(810) 733-5544

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Teresa Ennis-Decker, O.D.

Title

Owner

Phone

(989) 871-3559

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1790737161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 SHERIDAN RD",
            "city": "MILLINGTON",
            "state": "MI",
            "postal_code": "487469619",
            "telephone_number": "989-871-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4313 CORUNNA RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324152",
            "telephone_number": "810-733-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TERESA ENNIS-DECKER & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "ENNIS-DECKER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-871-3559",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.