Valerie Kassuba

Primary specialty

OpticianTaxonomy code 156FX1800X

License

228189 Issued in MI

Practice address

950 Edelweiss Village Pkwy
Gaylord, MI 49735-7441

Phone

(989) 732-5233

NPI assigned

Jul 31, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1114756756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 374",
            "city": "JOHANNESBURG",
            "state": "MI",
            "postal_code": "497510374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 EDELWEISS VILLAGE PKWY",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497357441",
            "telephone_number": "989-732-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSUBA",
        "first_name": "VALERIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "MI",
            "license": "228189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Kalkman
• Keith Allen Kamphuis, LMSW
• Kari Visser-Robel OD PC
• James David Karr Jr., BEHAVIOR TECHNICIAN
• Richard Thomas Kasbow, PA-C
• Kathryn Holmes Counseling
• Jeffery W Katke, LPC CMHP QIDP CMHP
• Kathy Ann Katke, LPC CMPH QMPH QIDP
• Steve Vincent Kaufmann, D.O.
• Adrienne Margaret Kelly, MD

• Optician in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Optician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.