Myeyedr Optometry of Michigan, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MYEYEDR OPTOMETRY OF MICHIGAN, LLC

Practice address

4482 Lake Michigan Dr NW
Walker, MI 49534-6304

Phone

(616) 791-6944

Fax

(616) 791-7268

NPI assigned

Mar 16, 2021

Organization subpart

No

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

Authorized official

Name

Sue Downes

Title

Secretary

Phone

(703) 847-8899

Specialties & licenses 1

Addresses

Other names 1

• RX Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Thomas Szczepanski, O.D.

  • Optometrist
  • Grand Rapids, MI
  • NPI 1316083843
  NPD
• Emily Elizabeth Vlietstra, OD

  • Optometrist
  • Rockford, MI
  • NPI 1841816220
  NPD

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1083299523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4482 LAKE MICHIGAN DR NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495346304",
            "telephone_number": "616-791-6944",
            "fax_number": "616-791-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF MICHIGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "DOWNES",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RX Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RX Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nolan Moore
• Lisa Moorhouse
• Grace Morelli
• Christine Mullan, LMSW
• Bethany Anne Murray, LMSW, CAAC
• Myeyedr Optometry of Michigan, LLC
• National Vision Inc
• Grace Elizabeth Neeley
• Leah Grace Nesburg, MA, CCC-SLP
• Taylor Neuhaus, MS

• Optometrist in Walker, MI
• Providers in Walker, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.