{
"Npi": {
"NPI": "1861559619",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SEALS TACIA & BARTZ OD PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1321 PINE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALMA",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48801-1242",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "989-463-1139",
"MailingAddressFaxNumber": "989-466-2808",
"FirstLinePracticeLocationAddress": "2865 S LINCOLN RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MT PLEASANT",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48858-9085",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "989-773-7747",
"PracticeLocationAddressFaxNumber": "989-779-1068",
"EnumerationDate": "01/02/2007",
"LastUpdateDate": "10/10/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NIXON",
"AuthorizedOfficialFirstName": "CIERRA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "BILLING MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "989-584-6868",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "4901003749",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}