NPIMap

Organization Active NPI

Co-Optical Eye Care Express Inc.

  • Optometrist
  • Muskegon HTS, MI
National Provider Identifier
1316122153
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002766 Issued in MI
Legal business name
CO-OPTICAL EYE CARE EXPRESS INC.
Practice address
499 W Norton Ave
Muskegon HTS, MI 49444-3727
Phone
(231) 733-2685
Fax
(231) 737-1236
NPI assigned
Dec 28, 2007
Last updated
Dec 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Authorized official

Name
Mark Shunta, O.D.NPI 1588775175
Title
O.D.
Phone
(231) 733-2685

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002766 MI Primary

Addresses

Primary practice location

499 W Norton Ave
Muskegon HTS, MI 49444-3727

Mailing address

499 W Norton Ave
Muskegon HTS, MI 49444-3727
Phone (231) 733-2685

Other identifiers 1

IdentifierTypeStateIssuer
900F111900OtherMIBCBSM

National Provider Directory

National Provider Directory

Locations

499 W Norton Ave
Norton Shores, MI 49444
Phone (231) 733-2685

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.

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1316122153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 W NORTON AVE",
            "city": "MUSKEGON HTS",
            "state": "MI",
            "postal_code": "494443727",
            "telephone_number": "231-733-2685",
            "fax_number": "231-737-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 W NORTON AVE",
            "city": "MUSKEGON HTS",
            "state": "MI",
            "postal_code": "494443727",
            "telephone_number": "231-733-2685",
            "fax_number": "231-737-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CO-OPTICAL EYE CARE EXPRESS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "SHUNTA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "O.D.",
        "authorized_official_telephone_number": "231-733-2685",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "900F111900",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon HTS, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.