Organization Active NPI

Northern Vision Eye Care, PC

  • Ophthalmology Physician
  • Traverse City, MI
National Provider Identifier
1801998182
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NORTHERN VISION EYE CARE, PC
Practice address
4033 Easter Sky Drive
Traverse City, MI 49684
Phone
(231) 932-9000
NPI assigned
Sep 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Robert K Butryn II, MD
Title
Owner
Phone
(231) 932-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4033 Easter Sky Drive
Traverse City, MI 49684

Mailing address

PO Box 1907
Traverse City, MI 49685-1907
Phone (231) 932-9000

Other identifiers 1

IdentifierTypeStateIssuer
CG7309OtherMIRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

4033 Eastern Sky Dr
Traverse City, MI 49684
Phone (231) 932-9000

Practitioners & affiliated clinicians

Practitioners 1

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": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1801998182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1907",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496851907",
            "telephone_number": "231-932-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 EASTER SKY DRIVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-932-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN VISION EYE CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "BUTRYN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-932-9000",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG7309",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.