NPIMap

Organization Active NPI

Heritage Optical Inc.

  • Optometrist
  • Detroit, MI
National Provider Identifier
1053642397
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003146 Issued in MI
Legal business name
HERITAGE OPTICAL INC.
Practice address
2678 E Jefferson Ave
Detroit, MI 48207-4129
Phone
(313) 259-6006
NPI assigned
Jan 27, 2010
Last updated
Jan 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Authorized official

Name
George P Barnes Jr.
Title
President, C.E.O.
Phone
(313) 863-9581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003146 MI Primary

Addresses

Primary practice location

2678 E Jefferson Ave
Detroit, MI 48207-4129

Mailing address

19010 Livernois Ave
Detroit, MI 48221-2259
Phone (313) 896-9581

National Provider Directory

National Provider Directory
Tax ID family
Heritage Optical Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1053642397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19010 LIVERNOIS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212259",
            "telephone_number": "313-896-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2678 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074129",
            "telephone_number": "313-259-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT, C.E.O.",
        "authorized_official_telephone_number": "313-863-9581",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.