NPIMap

Organization Active NPI

RK Atanasoff OD PC

  • Optometrist
  • Iron River, MI
National Provider Identifier
1912166166
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2518 Issued in MI
Legal business name
RK ATANASOFF OD PC
Practice address
131 W Genesee St
Iron River, MI 49935
Phone
(906) 265-9931
Fax
(906) 265-6202
NPI assigned
Jun 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Authorized official

Name
Dr. Raymond Krist Atanasoff, ODNPI 1376551788
Title
Optometrist
Phone
(906) 265-9931

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2518 MI Primary

Addresses

Primary practice location

131 W Genesee St
Iron River, MI 49935

Mailing address

131 W Genesee St
Iron River, MI 49935
Phone (906) 265-9931

Other identifiers 2

IdentifierTypeStateIssuer
900C665040OtherMIBLUE CROSS AND BLUE SHIELD
945047510MedicaidMI

National Provider Directory

National Provider Directory

Locations

131 W Genesee St
Iron River, MI 49935
Phone (906) 265-9931

Practitioners & affiliated clinicians

Practitioners 1

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": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1912166166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W GENESEE ST",
            "city": "IRON RIVER",
            "state": "MI",
            "postal_code": "49935",
            "telephone_number": "906-265-9931",
            "fax_number": "906-265-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W GENESEE ST",
            "city": "IRON RIVER",
            "state": "MI",
            "postal_code": "49935",
            "telephone_number": "906-265-9931",
            "fax_number": "906-265-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RK ATANASOFF OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "ATANASOFF",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "KRIST",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "906-265-9931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "2518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "900C665040",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945047510",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron River, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.