Jeffrey M Chadwick O D P C

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003807 Issued in MI

Legal business name

JEFFREY M CHADWICK O D P C

Practice address

325 E M 55
Tawas City, MI 48763-8211

Phone

(989) 362-2754

Fax

(989) 362-6231

NPI assigned

Oct 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Michael Chadwick, O.D.NPI 1720017312

Title

Owner

Phone

(989) 362-2754

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Jeffrey Michael Chadwick, O.D.

  • Optometrist
  • Tawas City, MI
  • NPI 1720017312
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1942500160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 M-55",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "48763",
            "telephone_number": "989-362-2754",
            "fax_number": "989-362-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E M 55",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487638211",
            "telephone_number": "989-362-2754",
            "fax_number": "989-362-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY M CHADWICK O D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "CHADWICK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-362-2754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alecia Marie Hughes, LPC
• Iosco Medical Care Facility
• Iosco Regional Educational Service Agency
• Amanda Jacques, FNP
• Amy Marie James, NP
• John L Lesneski DDS PLC
• Vincent Clifton Johnson, D.D.S.
• Jennifer L Jones, DO
• Kenneth A Jordan, MD
• Josip Petani MD PC

• Optometrist in Tawas City, MI
• Providers in Tawas City, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.