NPIMap

Organization Active NPI

Midwest Optometry Group, PLLC

  • Optometrist
  • Sturgis, MI
National Provider Identifier
1063586410
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002483 Issued in MI
Legal business name
MIDWEST OPTOMETRY GROUP, PLLC
Practice address
1500 S Centerville Rd
Sturgis, MI 49091-8245
Phone
(269) 651-4523
NPI assigned
Nov 19, 2006
Last updated
Jul 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Authorized official

Name
Dr. Bruce G Young, ODNPI 1780663765
Title
Owner
Phone
(517) 278-8248

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002483 MI Primary

Addresses

Primary practice location

1500 S Centerville Rd
Sturgis, MI 49091-8245

Mailing address

335 W Barnhart Rd
Coldwater, MI 49036-9263
Phone (517) 278-8248

National Provider Directory

National Provider Directory

Locations

1500 S Centerville Rd
Sturgis, MI 49091
Phone (269) 651-4523

Practitioners & affiliated clinicians

Practitioners 3

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": "1163894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1063586410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 W BARNHART RD",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490369263",
            "telephone_number": "517-278-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S CENTERVILLE RD",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490918245",
            "telephone_number": "269-651-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST OPTOMETRY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-19",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-278-8248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgis, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.