Swan Optometry Services, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003186 Issued in MI

Legal business name

SWAN OPTOMETRY SERVICES, PC

Practice address

25 N Main St
Rockford, MI 49341-1281

Phone

(616) 866-3077

Fax

(616) 866-4408

NPI assigned

Oct 15, 2010

Organization subpart

No

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

Authorized official

Name

Mark Swan, OD, MEDNPI 1386665016

Title

Owner

Phone

(616) 866-3077

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• In Focus Eyecare of Rockford Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Edward Swan, OD MED

  • Optometrist
  • Big Rapids, MI
  • NPI 1386665016
  Medicare reassignment Care Compare group NPD Authorized official
• Morgan Cornelius, OD

  • Optometrist
  • Byron Center, MI
  • NPI 1467012401
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473379200000",
    "number": "1124338736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N MAIN ST",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411281",
            "telephone_number": "616-866-3077",
            "fax_number": "616-866-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N MAIN ST",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411281",
            "telephone_number": "616-866-3077",
            "fax_number": "616-866-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWAN OPTOMETRY SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2016-09-09",
        "status": "A",
        "authorized_official_last_name": "SWAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-866-3077",
        "authorized_official_credential": "OD, MED"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003186",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "MI",
            "license": "4901003186",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "900006367",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4401840",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "999998001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "M5003186",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "In Focus Eyecare of Rockford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trew J. Stransky, D.O.
• Scott R Strickland, DDS
• Alexandra Stuva
• Karley Sullivan, MA CCC-SLP
• Rebecca Ann Sundling, DPM, MPH
• Teri Lynn Sweeney
• Michael Galen Swinger, PT
• Abby Lynn Synhorst, RN
• Kathryn Szetela
• Stacy Brooke Tarrh, DPT

• Optometrist in Rockford, MI
• Providers in Rockford, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.