NPIMap

Organization Active NPI

Jeffrey K Chaulk MD PC

Doing business as Alpine Eye Care

  • Ophthalmology Physician
  • Cheboygan, MI
National Provider Identifier
1902093701
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301405077 Issued in MI
Legal business name
JEFFREY K CHAULK MD PC
Doing business as
Alpine Eye Care
Practice address
810 S Main St
Suite 3
Cheboygan, MI 49721-2290
Phone
(231) 627-3169
Fax
(231) 627-3099
NPI assigned
Sep 26, 2007
Last updated
Feb 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Dr. Jeffrey K Chaulk, MDNPI 1710925334
Title
Owner
Phone
(989) 732-6455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004074 MI
Optometrist 152W00000X 4901003939 MI
Ophthalmology Physician 207W00000X 4301405077 MI Primary
Ophthalmology Physician 207W00000X 4301081575 MI

Addresses

Primary practice location

810 S Main St
Suite 3
Cheboygan, MI 49721-2290

Mailing address

PO Box 1665
Gaylord, MI 49734-5665
Phone (989) 732-6455

Other identifiers 1

IdentifierTypeStateIssuer
3038290MedicaidMI

Other names 1

  • Alpine Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

810 S Main St
Ste 3
Cheboygan, MI 49721
Phone (231) 627-3169

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1902093701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1665",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497345665",
            "telephone_number": "989-732-6455",
            "fax_number": "989-732-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S MAIN ST",
            "address_2": "SUITE 3",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212290",
            "telephone_number": "231-627-3169",
            "fax_number": "231-627-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY K CHAULK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "CHAULK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-732-6455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004074",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003939",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301405077",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301081575",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3038290",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpine Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cheboygan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.