Life Vision Eyecare, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

LIFE VISION EYECARE, PLLC

Doing business as

Life Vision Eyecare

Practice address

5770 Red Arrow Hwy
Stevensville, MI 49127-1159

Phone

(269) 367-2626

NPI assigned

Jul 14, 2020

Last updated

Oct 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly May Cooper, ODNPI 1457670846

Title

Ao

Phone

(269) 367-2626

Specialties & licenses 1

Addresses

Other names 1

• Life Vision Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly May Cooper, O.D.

  • Optometrist
  • Stevensville, MI
  • NPI 1457670846
  Medicare reassignment Care Compare group NPD Authorized official
• Patrick William Graves, OD

  • Optometrist
  • Stevensville, MI
  • NPI 1548746449
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1295343465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 RED ARROW HWY",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491271159",
            "telephone_number": "269-367-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 RED ARROW HWY",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491271159",
            "telephone_number": "269-367-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE VISION EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "MAY",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "269-367-2626",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Vision Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tina W Latham-Enix, C.M.T.
• Lavender and Sage Therapeutic Massage, LLC
• Jenny-Anh Phuong Le, PHARM.D
• Sarah Leese, PA-C
• Life Steps Family Counseling
• Kyesha Ariane Lipscomb, PHARM. D.
• Anna Lonto, DPT
• Henry D Lyon, D.D.S.
• Jeremy Michael Malzon, MA, LPC
• Heather A Marten, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.