Robert C Huizenga O D P C

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002647 Issued in MI

Legal business name

ROBERT C HUIZENGA O D P C

Practice address

1884 Baldwin St
Jenison, MI 49428-8902

Phone

(616) 457-2020

Fax

(616) 988-5776

NPI assigned

Dec 9, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Robert C Huizenga, O D P C

Title

Doctor

Phone

(616) 457-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1295064962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1884 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288902",
            "telephone_number": "616-457-2020",
            "fax_number": "616-988-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1884 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288902",
            "telephone_number": "616-457-2020",
            "fax_number": "616-988-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C HUIZENGA O D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "HUIZENGA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "616-457-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O D P C"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY - OPTOMETRIST",
            "identifier": "152W0000X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Jenison, MI
• Providers in Jenison, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.

Verify at the official NPI Registry.