Active NPI
Northshore Optometry LLC
- Optometrist
- N Muskegon, MI
National Provider Identifier
1114103140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 49010003090
- Legal business name
- NORTHSHORE OPTOMETRY LLC
- Practice address
- 1179 Whitehall Rd
Suite B
N Muskegon, MI 49445-2497 - Phone
- (231) 744-3573
- Fax
- (231) 719-9016
- NPI assigned
- Jan 22, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle Lee Burkhardt Bullion
- Title
- Owner
- Phone
- (231) 744-3573
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 49010003090 | MI | Primary |
Addresses
Primary practice location
1179 Whitehall Rd
Suite B
N Muskegon, MI 49445-2497
Mailing address
1179 Whitehall Rd Ste B
N Muskegon, MI 49445-2497
Phone (231) 744-3573
Other names 1
- Korinne Swain, O.D.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120808000507 | MI | Part B Supplier - Clinic/Group Practice | 9436305307 |
Receives reassigned benefits from 2 practitioners Practice locations: North Muskegon, MI |
National Provider Directory
National Provider DirectoryLocations
1179 Whitehall Rd
Ste B
North Muskegon, MI 49445
Phone (231) 744-3573
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787702400000",
"number": "1114103140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1179 WHITEHALL RD STE B",
"city": "N MUSKEGON",
"state": "MI",
"postal_code": "494452497",
"telephone_number": "231-744-3573",
"fax_number": "231-719-9016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1179 WHITEHALL RD",
"address_2": "SUITE B",
"city": "N MUSKEGON",
"state": "MI",
"postal_code": "494452497",
"telephone_number": "231-744-3573",
"fax_number": "231-719-9016"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHSHORE OPTOMETRY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-22",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A",
"authorized_official_last_name": "BURKHARDT BULLION",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "231-744-3573"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "MI",
"license": "49010003090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Korinne Swain, O.D.",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in N Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.