Active NPI
Rodney Alan Hathaway, O.D. PHD.
- Optometrist
- Monroe, MI
National Provider Identifier
1093866899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901002726
- Practice address
- 15175 S Dixie Hwy
Monroe, MI 48161-5038 - Phone
- (734) 243-0370
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901002726 | MI | Primary |
Addresses
Primary practice location
15175 S Dixie Hwy
Monroe, MI 48161-5038
Mailing address
15175 S Dixie Hwy
Monroe, MI 48161
Phone (734) 243-0370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5085557 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901002726 | MI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196294400000",
"number": "1093866899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15175 S DIXIE HWY",
"city": "MONROE",
"state": "MI",
"postal_code": "48161",
"telephone_number": "734-243-0370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15175 S DIXIE HWY",
"city": "MONROE",
"state": "MI",
"postal_code": "481615038",
"telephone_number": "734-243-0370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATHAWAY",
"first_name": "RODNEY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "O.D. PHD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2007-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901002726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5085557",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.