Grand Rapids Eye Care 2820 PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

GRAND RAPIDS EYE CARE 2820 PLLC

Practice address

2820 E Beltline LN NE
Grand Rapids, MI 49525-9432

Phone

(616) 363-5413

Fax

(616) 363-4211

NPI assigned

Apr 10, 2007

Last updated

Jan 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Colin Davis, ODNPI 1427108430

Title

Owner

Phone

(616) 363-5413

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacquelyn Lee Cosgrove Malleis, O.D.

  • Optometrist
  • Grand Rapids, MI
  • NPI 1568999332
  Medicare reassignment Care Compare group NPD
• Mark Collins Davis, OD

  • Optometrist
  • Grand Rapids, MI
  • NPI 1427108430
  Medicare reassignment NPD Authorized official
• Adam Hoffhines, OD

  • Optometrist
  • Grand Rapids, MI
  • NPI 1821613225
  Medicare reassignment Care Compare group NPD
• Autumn Rae Nunn Killop, OD, MPH

  • Optometrist
  • Grand Rapids, MI
  • NPI 1164098893
  Medicare reassignment Care Compare group NPD
• Lillian Thorp Kalaczinski, O.D.

  • Optometrist
  • Big Rapids, MI
  • NPI 1356429757
  Medicare reassignment Care Compare group NPD
• Chad Martin Kresnak, O.D.

  • Optometrist
  • Hastings, MI
  • NPI 1134329097
  Medicare reassignment Care Compare group
• Gary W. Sokol, O.D.

  • Optometrist
  • Grand Ledge, MI
  • NPI 1124001631
  Medicare reassignment NPD

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1053534040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 E BELTLINE LN NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259432",
            "telephone_number": "616-363-5413",
            "fax_number": "616-363-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 E BELTLINE LN NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259432",
            "telephone_number": "616-363-5413",
            "fax_number": "616-363-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RAPIDS EYE CARE 2820 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "COLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-363-5413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.