Individual provider Active NPI

Ann A Walker, O.D.

  • Optometrist
  • Grand Blanc, MI
National Provider Identifier
1114019114
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002877 Issued in MI
Practice address
11225 S Saginaw St
Grand Blanc, MI 48439-1285
Phone
(810) 694-3937
Fax
(810) 694-9876
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002877 MI Primary

Addresses

Primary practice location

11225 S Saginaw St
Grand Blanc, MI 48439-1285

Mailing address

11225 S Saginaw St
Grand Blanc, MI 48439-1285
Phone (810) 694-3937

Other identifiers 5

IdentifierTypeStateIssuer
09945464OtherMIHEALTHPLUS OF MICHIGAN
16485OtherM-CARE
1006992OtherMCLAREN HEALTHPLAN
900B511570OtherMIBLUE CROSS BLUE SHIELD
943020553MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101008000912 MI Practitioner - Optometry 0244346385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Blanc Eyes PLLCGroup PAC ID 9830304492, 5 clinicians

Practice addresses (Care Compare)

11225 S Saginaw St
Grand Blanc, MI 48439-1285
Phone (810) 694-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Chiropractic Care, Inc CurrentSince Feb 15, 2011 Accepting new patients
Grand Blanc Eyes PLLC Optometrist CurrentSince Aug 3, 2002 Accepting new patients

Locations

11225 S Saginaw St
Grand Blanc, MI 48439
Phone (810) 694-3937

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1114019114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11225 S SAGINAW ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391285",
            "telephone_number": "810-694-3937",
            "fax_number": "810-694-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11225 S SAGINAW ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391285",
            "telephone_number": "810-694-3937",
            "fax_number": "810-694-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ANN",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS OF MICHIGAN",
            "identifier": "09945464",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "16485",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTHPLAN",
            "identifier": "1006992",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900B511570",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "943020553",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.