Mary Evelyn Miller, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004486 Issued in MI

Practice address

10085 Buchanan Rd
Canadian Lakes, MI 49346-9762

Phone

(231) 972-3937

Fax

(231) 972-1212

NPI assigned

Jul 25, 2008

Last updated

Sep 17, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mary Evelyn Phillips Former name

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

Specialty

Optometry

Education

Ferris State College - College of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Canadian Lakes Eyecare, P.L.L.C.Group PAC ID 4789735333, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canadian Lakes Eyecare, P.L.L.C.

  dba Canadian Lakes Eyecare

  • Optometrist
  • Canadian Lakes, MI
  • NPI 1780810598
  Medicare reassignment Care Compare group NPD
• Kaczmarski Hearing Services, Inc

  • Audiologist-Hearing Aid Fitter
  • Wyoming, MI
  • NPI 1114096716
  NPD
• Luxottica Retail North America Inc

  dba Lenscrafters #05578

  • Eyewear Supplier
  • Midland, MI
  • NPI 1053457101
  NPD (past)

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1285899542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10085 BUCHANAN RD",
            "city": "CANADIAN LAKES",
            "state": "MI",
            "postal_code": "493469762",
            "telephone_number": "231-972-3937",
            "fax_number": "231-972-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10085 BUCHANAN RD",
            "city": "CANADIAN LAKES",
            "state": "MI",
            "postal_code": "493469762",
            "telephone_number": "231-972-3937",
            "fax_number": "231-972-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARY",
        "middle_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "PHILLIPS",
            "middle_name": "EVELYN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Patrece Dressander, M.P.T.
• Michelle Rose Godfrey, PA-C
• Mecosta County Medical Center
• Mecosta County Medical Center (Corewell Health Big Rapids Hospital Family Medicine - Canadian Lakes)
• Mecosta County Medical Center (Spectrum Health Big Rapids Home Care)
• Northland Hearing Centers, Inc.
• Alison Scsavnicki

• Optometrist in Canadian Lakes, MI
• Providers in Canadian Lakes, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.