Sunrise Vision Care

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003215 Issued in MI

Legal business name

SUNRISE VISION CARE

Practice address

621 E Lake St
Tawas City, MI 48763-9213

Phone

(989) 299-8409

Fax

(989) 984-0931

NPI assigned

Dec 10, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Susan Marie Moon, O.D.NPI 1497912174

Title

Manager Member

Phone

(989) 984-0929

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• Susan Marie Moon, O.D.

  • Optometrist
  • Tawas City, MI
  • NPI 1497912174
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1982933586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 111",
            "city": "EAST TAWAS",
            "state": "MI",
            "postal_code": "487300111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E LAKE ST",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639213",
            "telephone_number": "989-299-8409",
            "fax_number": "989-984-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE VISION CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "989-984-0929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Joseph Health Enterprises
• St. Joseph Home Health & Hospice
• Erica Ann Stewart, CPHT
• Shelley Marie Stewart
• Michele M Stockton, DC
• Surya N Sankaran MD PC
• Tawas Bay Family Practice PC
• Tawas Chiropractic Center, Inc
• Tawas City Opco LLC
• Tawas Foot Clinic

• 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 Apr 14, 2010; 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.