Individual provider Active NPI

Amanda Katherine Lovelace, OD

  • Optometrist
  • Ann Arbor, MI
National Provider Identifier
1053101956
Registry record updated Jun 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005869 Issued in MI
Practice address
215 N Maple Rd Ste B1
Ann Arbor, MI 48103-2823
Phone
(734) 206-9141
NPI assigned
May 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005869 MI Primary

Addresses

Primary practice location

215 N Maple Rd Ste B1
Ann Arbor, MI 48103-2823

Mailing address

2835 Marshall St
Ann Arbor, MI 48108-1828
Phone (540) 641-5230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4901005869MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision Inc Optometrist CurrentSince Jun 3, 2025 Accepting new patients

Locations

215 N Maple Rd
#B1
Ann Arbor, MI 48103
Phone (734) 206-9141

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749254400000",
    "number": "1053101956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 MARSHALL ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081828",
            "telephone_number": "540-641-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N MAPLE RD STE B1",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032823",
            "telephone_number": "734-206-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "AMANDA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-06-07",
        "certification_date": "2025-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2025; 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.