B. JEFFREY PULK, P.C. (NPI# 1528237690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528237690 |
| Entity Type | Organization |
| Organization Name | B. JEFFREY PULK, P.C. |
| Other Organization Name | OLD TOWN OPTICAL |
| Practice Address |
515 S Union St Traverse City MI 49684-3246 |
| Practice Telephone | 2319460333 |
| Practice Fax Number | 2319461665 |
| Mailing Telephone | 2319460333 |
| Mailing Fax Number | 2319461665 |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2008-02-22 |
| Authorized Official Name | BERNARD JEFFREY PULK (CEO) |
| Authorized Official Telephone | 2319460333 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
4901004124 | MI | Eye and Vision Services Providers |
| N | 152WS0006X |
Optometrist Specialization: Sports Vision |
4901004124 | MI | Eye and Vision Services Providers |
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
4901004124 | MI | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 4901004124 | MI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4351130 | 05 |
| Other Name | Type Code |
|---|---|
| Old Town Optical | Doing Business As Name - Organization |
| Street Address |
515 S UNION ST |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-3246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619039864 | Nathan G Baas | Optometrist | 515 S Union St, Traverse City, MI 49684-3246 | 2006-12-14 |
| 1821302548 | Baas Optometry PC | Optometrist | 515 S Union St, Traverse City, MI 49684-3246 | 2010-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689274516 | Soave Eye Care | Optometrist | 522 S Garfield Ave Ste A, Traverse City, MI 49686-3485 | 2020-10-29 |
| 1629302468 | Scott James Soave | Optometrist | 1325 W South Airport Rd, Traverse City, MI 49686-4760 | 2009-09-27 |
| 1922242825 | Pamela S. Gilmartin | Optometrist | 822 Cass St, Traverse City, MI 49684-3230 | 2009-04-23 |
| 1467633552 | Dennis E. Pace, O.d., Plc | Optometrist | 1212 W South Airport Rd, Traverse City, MI 49686-4759 | 2007-11-17 |
| 1659412302 | Eric Connick | Optometrist | 2279 S Airport Rd W, Traverse City, MI 49684-4713 | 2007-02-08 |
| 1619039864 | Nathan G Baas | Optometrist | 515 S Union St, Traverse City, MI 49684-3246 | 2006-12-14 |
| 1235163924 | Carolyn Marie Pierce | Optometrist | 872 Munson Ave Ste B, Traverse City, MI 49686 | 2006-07-10 |
| 1760436042 | John Christopher Hanford | Optometrist | 2640 Crossing Cir, Traverse City, MI 49684-7930 | 2006-05-20 |
| 1194791244 | Ian Hamilton Dunscombe | Optometrist | 1325 S Airport Rd W, Traverse City, MI 49686-4760 | 2006-02-28 |
| 1205814779 | Mark D Noss | Optometrist | 328 Munson Ave, Traverse City, MI 49686-3040 | 2006-01-05 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.