NPIMap

Organization Active NPI

Advanced Vision Centers LTD

  • Optometrist
  • Washington, MI
National Provider Identifier
1013966340
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002788 Issued in MI
Legal business name
ADVANCED VISION CENTERS LTD
Practice address
64641 Van Dyke Rd
Washington, MI 48095-2584
Phone
(586) 752-4477
Fax
(586) 752-3270
NPI assigned
May 5, 2006
Last updated
Jun 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Authorized official

Name
Fred Lichota, O.D.
Title
Owner
Phone
(586) 752-4477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002788 MI Primary

Addresses

Primary practice location

64641 Van Dyke Rd
Washington, MI 48095-2584

Mailing address

64641 Van Dyke Rd
Washington, MI 48095-2584
Phone (586) 752-4477

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1013966340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64641 VAN DYKE RD",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480952584",
            "telephone_number": "586-752-4477",
            "fax_number": "586-752-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64641 VAN DYKE RD",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480952584",
            "telephone_number": "586-752-4477",
            "fax_number": "586-752-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VISION CENTERS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "LICHOTA",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-752-4477",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.