NPIMap

Organization Active NPI

Michigan Medical Patient Care

  • Optometrist
  • Grand Rapids, MI
National Provider Identifier
1083632426
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MICHIGAN MEDICAL PATIENT CARE
Practice address
4069 Lake Dr SE
S-315
Grand Rapids, MI 49546-8816
Phone
(616) 974-2890
NPI assigned
Jul 17, 2006
Last updated
Mar 2, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
MICHIGAN MEDICAL PATIENT CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Authorized official

Name
Scott Harring
Title
Cfo
Phone
(616) 974-4889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

4069 Lake Dr SE
S-315
Grand Rapids, MI 49546-8816

Mailing address

4085 Burton St SE
S-200
Grand Rapids, MI 49546-2444

National Provider Directory

National Provider Directory
Tax ID family
MMPC Weight Management70 organizations share this tax ID, including this one
Part of
MMPC Weight Management

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

4069 Lake Dr SE
#S315
Grand Rapids, MI 49546
Phone (616) 974-2890

4085 Burton St SE
#S200
Grand Rapids, MI 49546

Practitioners & affiliated clinicians

Practitioners 12

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": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1083632426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 BURTON ST SE",
            "address_2": "S-200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4069 LAKE DR SE",
            "address_2": "S-315",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468816",
            "telephone_number": "616-974-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN MEDICAL PATIENT CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHIGAN MEDICAL PATIENT CARE",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "HARRING",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-974-4889"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

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