Van Optical, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003594 Issued in MI

Legal business name

VAN OPTICAL, P.C.

Practice address

1601 E US Highway 223
Adrian, MI 49221-4454

Phone

(517) 265-9883

Fax

(517) 265-9796

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David Gordon Vanotteren, O.D.NPI 1477649499

Title

President

Phone

(734) 649-4978

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Van Optical, P.C.

  • Optometrist
  • Saline, MI
  • NPI 1962735282

  O20051229000684

  Same enrollment

Tax ID family

Van Optical PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Van Optical, P.C.

  • Optometrist
  • Saline, MI
  • NPI 1962735282
  NPD tax ID

Locations

Practitioners 3

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

• David Gordon Vanotteren, O.D.

  • Optometrist
  • Adrian, MI
  • NPI 1477649499
  NPD Authorized official
• Michael Dante Curcione, O.D.

  • Optometrist
  • Adrian, MI
  • NPI 1720157787
  NPD
• Kelly D Carrier, O.D.

  • Optometrist
  • Dexter, MI
  • NPI 1770537250
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519344000000",
    "number": "1164518106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8850 SALINE MILAN RD",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481768826",
            "telephone_number": "734-944-4404",
            "fax_number": "734-944-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E US HIGHWAY 223",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492214454",
            "telephone_number": "517-265-9883",
            "fax_number": "517-265-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN OPTICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2018-02-23",
        "status": "A",
        "authorized_official_last_name": "VANOTTEREN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-649-4978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josh Adam Valdez
• Lauren Elizabeth Valdez, LLMSW
• Sandy Valdez
• Christopher Donald Valkier, DPM
• Sophia Maria Ann Valkier, DPM
• Abbie Rae Vanamburg, LMT
• Kelsie Elizabeth Vanbeelen
• Janice Vanbrunt, LLMSW
• Kandiss Vancoppenolle
• Derek Vandewater

• All providers in Adrian, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.