Renee Marie Korican, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003731 Issued in MI

Practice address

6740 Cascade Rd SE
Grand Rapids, MI 49546-6888

Phone

(616) 942-9888

Fax

(616) 942-0345

NPI assigned

May 15, 2007

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hiemstra Optical Company

  • Optician
  • Paw Paw, MI
  • NPI 1841371556
  Medicare reassignment NPD
• Mid Michigan Eye Care Center, PC

  • Ophthalmology Physician
  • Jackson, MI
  • NPI 1649275041

  Optometrist

  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174739932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 CYPRESS TRAIL DR SE",
            "address_2": "GRAND RAPIDS",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468634",
            "telephone_number": "616-437-0164",
            "fax_number": "616-942-0345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6740 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466888",
            "telephone_number": "616-942-9888",
            "fax_number": "616-942-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORICAN",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael James Kopka I, MD
• Jessica Rae Kopmeyer, LMSW
• Polina Koptelova, PA-C
• Djana Korajac
• Emma Korfker
• Christine Korlewitz, MD
• Carleen Anna Kormos, LLMSW
• Amy Korn, PT
• Marc Alexander Korn, MD
• Makinni Marie Kornak-Kotarba

• Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.