RX Optical Laboratories, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

RX OPTICAL LABORATORIES, INC.

Practice address

6123 S Westnedge Ave
Portage, MI 49002-2811

Phone

(269) 327-7079

NPI assigned

Dec 31, 2006

Organization subpart

No

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

Authorized official

Name

Stephan Jepson

Title

President

Phone

(269) 342-0003

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1164588232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 S PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490012759",
            "telephone_number": "269-342-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6123 S WESTNEDGE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490022811",
            "telephone_number": "269-327-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RX OPTICAL LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-31",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "JEPSON",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-342-0003"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Ruddock
• Michael Paul Ruesink, M.A; M.S. ED
• Andrea Ruiz
• Cadi Rulison
• David Lee Russell, ED.D.
• Stephanie Sabater-Geib, PA-C
• Sharon Roebuck Sabel, RN
• Thomas Sackett
• Sacred Healing Therapeutic Services LLC
• Safa Bahar Sadat

• All providers in Portage, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.