Active NPI
Village Optical Inc
- Optometrist
- Grosse Pointe Park, MI
National Provider Identifier
1295864759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- L907492
- Legal business name
- VILLAGE OPTICAL INC
- Practice address
- 16841 Kercheval PL
Grosse Pointe Park, MI 48230-1553 - Phone
- (313) 885-5400
- NPI assigned
- Mar 2, 2007
- Last updated
- May 15, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael Lowe, O.D.
- Title
- Doctor Owner
- Phone
- (313) 885-5400
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | L907492 | MI | Primary |
Addresses
Primary practice location
16841 Kercheval PL
Grosse Pointe Park, MI 48230-1553
Mailing address
19992 Country Club Dr
Harper Woods, MI 48225-1622
Phone (313) 885-1733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
16841 Kercheval Pl
Grosse Pointe Park, MI 48230
Phone (313) 885-5400
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Optometrist
- Grosse Pointe Park, MI
- NPI 1902934573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1242345600000",
"number": "1295864759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19992 COUNTRY CLUB DR",
"city": "HARPER WOODS",
"state": "MI",
"postal_code": "482251622",
"telephone_number": "313-885-1733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16841 KERCHEVAL PL",
"city": "GROSSE POINTE PARK",
"state": "MI",
"postal_code": "482301553",
"telephone_number": "313-885-5400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VILLAGE OPTICAL INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-02",
"last_updated": "2009-05-15",
"status": "A",
"authorized_official_last_name": "LOWE",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "DOCTOR OWNER",
"authorized_official_telephone_number": "313-885-5400",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "MI",
"license": "L907492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grosse Pointe Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; 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.