NPIMap

Organization Active NPI

Linden Family Eyecare PC

  • Low Vision Rehabilitation Optometrist
  • Linden, MI
National Provider Identifier
1114373727
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
License
4901004592 Issued in MI
Legal business name
LINDEN FAMILY EYECARE PC
Practice address
123 E Broad St
Linden, MI 48451-9126
Phone
(810) 735-9988
NPI assigned
May 12, 2016
Last updated
May 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Authorized official

Name
Dr. Gerianne J Mulanix, ODNPI 1245544949
Title
President/Secretary
Phone
(810) 656-9713

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)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 4901004592 MI Primary

Addresses

Primary practice location

123 E Broad St
Linden, MI 48451-9126

Mailing address

7143 W Rolston Rd
Linden, MI 48451-9766
Phone (810) 735-9988

Other names 1

  • Linden Family Eyecare CO Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160718001127 MI Part B Supplier - Clinic/Group Practice 0345532032 Receives reassigned benefits from 3 practitioners
Practice locations: Linden, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1463011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1114373727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7143 W ROLSTON RD",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484519766",
            "telephone_number": "810-735-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E BROAD ST",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484519126",
            "telephone_number": "810-735-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDEN FAMILY EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "MULANIX",
        "authorized_official_first_name": "GERIANNE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/SECRETARY",
        "authorized_official_telephone_number": "810-656-9713",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "MI",
            "license": "4901004592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Linden Family Eyecare CO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Linden, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.

Verify at the official NPI Registry.