NPIMap

Individual provider Active NPI

Gerald Kolk, O.D.

  • Optometrist
  • Holland, MI
National Provider Identifier
1275517286
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002396 Issued in MI
Practice address
456 E 16TH St
Suite 1
Holland, MI 49423-3788
Phone
(616) 395-2020
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002396 MI Primary

Addresses

Primary practice location

456 E 16TH St
Suite 1
Holland, MI 49423-3788

Mailing address

456 E 16TH St
Suite 1
Holland, MI 49423-3788
Phone (616) 395-2020

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

OrganizationSpecialtyStatusNew patients
SVC Inc. Optometrist Past Accepting new patients
Elder Eye Care Group PLC Optometrist PastSince Nov 21, 2016 Accepting new patients
West Coast Eyecare PLLC Optometrist Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1275517286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 E 16TH ST",
            "address_2": "SUITE 1",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233788",
            "telephone_number": "616-395-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 E 16TH ST",
            "address_2": "SUITE 1",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233788",
            "telephone_number": "616-395-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLK",
        "first_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.