Thomas Eric Herzog Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

THOMAS ERIC HERZOG INC

Practice address

W7164 Green Valley Rd
Spooner, WI 54801-6605

Phone

(715) 635-3127

Fax

(715) 635-3316

NPI assigned

Nov 10, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Eric Herzog

Title

Optician/Owner

Phone

(715) 635-3127

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Indianhead Eye Clinic Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Lynn Kocemba, OD

  • Optometrist
  • Hayward, WI
  • NPI 1467434647
  NPD (past)
• Lee W Purdy, O.D.

  • Optometrist
  • Tomahawk, WI
  • NPI 1891829826
  NPD (past)
• Dawn Lenee Reed, O.D.

  • Optometrist
  • Spooner, WI
  • NPI 1740337948
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1902887508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548010446",
            "telephone_number": "715-635-3127",
            "fax_number": "715-635-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W7164 GREEN VALLEY RD",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548016605",
            "telephone_number": "715-635-3127",
            "fax_number": "715-635-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS ERIC HERZOG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OPTICIAN/OWNER",
        "authorized_official_telephone_number": "715-635-3127",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "DG1708",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38711400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indianhead Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tabletop Recovery LLC
• Angela Kay Tellefson, PHARMD
• The Duluth Clinic, LTD
• Deborah Thoennes, LPC
• Kathleen Ann Thom, R.N.
• Leslie D Thornburg, OD
• Erica M Tison
• Mark Aeppli Van Etten
• Erin N Vanguilder, COTA
• Washburn County Health and Human Services Department

• Clinic/Center in Spooner, WI
• Providers in Spooner, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; 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.