Active NPI
Nelson Grey Edwards, O.D.
- Optometrist
- Fowlerville, MI
National Provider Identifier
1194804583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901003131
- Practice address
- 136 E Grand River Ave
Fowlerville, MI 48836-5136 - Phone
- (517) 223-9988
- Fax
- (517) 223-9071
- NPI assigned
- Nov 4, 2006
- Last updated
- Oct 7, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901003131 | MI | Primary |
Addresses
Primary practice location
136 E Grand River Ave
Fowlerville, MI 48836-5136
Mailing address
136 E Grand River Ave
PO Box 618
Fowlerville, MI 48836-5136
Phone (517) 223-9988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lo Optical, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254873600000",
"number": "1194804583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 E GRAND RIVER AVE",
"address_2": "PO BOX 618",
"city": "FOWLERVILLE",
"state": "MI",
"postal_code": "488365136",
"telephone_number": "517-223-9988",
"fax_number": "517-223-9071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 E GRAND RIVER AVE",
"city": "FOWLERVILLE",
"state": "MI",
"postal_code": "488365136",
"telephone_number": "517-223-9988",
"fax_number": "517-223-9071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "NELSON",
"middle_name": "GREY",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-04",
"last_updated": "2009-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901003131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fowlerville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.