Individual provider Active NPI

Amanda Elizabeth Darnell, O.D.

  • Optometrist
  • Ann Arbor, MI
National Provider Identifier
1093965469
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004498 Issued in MI
Practice address
3601 Washtenaw Ave
Ann Arbor, MI 48104-5277
Phone
(734) 973-1969
NPI assigned
Sep 23, 2008
Last updated
Sep 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004498 MI Primary

Addresses

Primary practice location

3601 Washtenaw Ave
Ann Arbor, MI 48104-5277

Mailing address

330 Judd Rd
Milan, MI 48160-8913
Phone (616) 745-4424

Other identifiers 1

IdentifierTypeStateIssuer
223498755MedicaidMI

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4901004498MIMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1093965469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 JUDD RD",
            "city": "MILAN",
            "state": "MI",
            "postal_code": "481608913",
            "telephone_number": "616-745-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 WASHTENAW AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045277",
            "telephone_number": "734-973-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARNELL",
        "first_name": "AMANDA",
        "middle_name": "ELIZABETH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223498755",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.