Medical Village Optical Shoppe Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

MEDICAL VILLAGE OPTICAL SHOPPE INC.

Practice address

31815 Southfield Rd
Suite #12
Beverly Hills, MI 48025-5471

Phone

(248) 645-2220

Fax

(877) 547-8277

NPI assigned

May 26, 2016

Organization subpart

No

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

Authorized official

Name

Roy Knoerr

Title

President

Phone

(248) 645-2220

Specialties & licenses 4

Addresses

Other names 1

• Optical Designs Doing business as

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1033567490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31815 SOUTHFIELD RD",
            "address_2": "SUITE #12",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255471",
            "telephone_number": "248-645-2220",
            "fax_number": "877-547-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31815 SOUTHFIELD RD",
            "address_2": "SUITE #12",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255471",
            "telephone_number": "248-645-2220",
            "fax_number": "877-547-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL VILLAGE OPTICAL SHOPPE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "KNOERR",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-645-2220"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optical Designs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Louise McKendrick, APRN BC
• Kelly McLaughlin, MSW
• Kendall Rose McLeod, RD
• Medical Lane LLC
• Medical Village Optical Shoppe Inc
• Metro Medical & Manual Therapies LLC
• Michael Pochron, MD,PC
• Lisa D Michaux, APRN, BC
• Michigan Home Care Physicians
• Michigan Orthopaedic Surgeons PLLC

• Optician in Beverly Hills, MI
• Providers in Beverly Hills, MI by specialty
• Optician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.