Organization Active NPI

Marla J Price DO PLLC

Doing business as Byrd and Wyandotte Eye Clinic'

  • Ophthalmology Physician
  • Wyandotte, MI
National Provider Identifier
1083894349
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MARLA J PRICE DO PLLC
Doing business as
Byrd and Wyandotte Eye Clinic'
Practice address
100 Oak St
Wyandotte, MI 48192-5134
Phone
(734) 284-2444
Fax
(735) 284-5155
NPI assigned
Nov 5, 2007
Last updated
Jan 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Dr. Marla Jeanne Price, DONPI 1134188469
Title
Physician
Phone
(734) 284-2444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MP008968 MI
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

100 Oak St
Wyandotte, MI 48192-5134

Mailing address

100 Oak St
Wyandotte, MI 48192-5134
Phone (734) 284-2444

Other identifiers 2

IdentifierTypeStateIssuer
2996126MedicaidMI
MP008968OtherMILICENSE

Other names 1

  • Byrd and Wyandotte Eye Clinic' Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080213000370 MI Part B Supplier - Clinic/Group Practice 3375626492 Receives reassigned benefits from 5 practitioners
Practice locations: Wyandotte, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2284890Byrd and Wyandotte Eye Clinic100 Oak Street, Wyandotte, MI 48192Certificate of waiverJun 28, 2027

National Provider Directory

National Provider Directory

Locations

3677 Fort St
Lincoln Park, MI 48146
Phone (313) 383-1300

100 Oak St
Wyandotte, MI 48192
Phone (734) 284-2444

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": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1083894349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OAK ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925134",
            "telephone_number": "734-284-2444",
            "fax_number": "735-284-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OAK ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925134",
            "telephone_number": "734-284-2444",
            "fax_number": "735-284-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLA J PRICE DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "MARLA",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "734-284-2444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "MP008968",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2996126",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MP008968",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Byrd and Wyandotte Eye Clinic'",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.