NPIMap

Organization Active NPI

Gro Optical, LLC

Doing business as Michigan Optical

  • Eyewear Supplier
  • Grand Rapids, MI
National Provider Identifier
1336849074
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
GRO OPTICAL, LLC
Practice address
511 Wilson Ave NW Ste E
Grand Rapids, MI 49534-7986
Phone
(616) 301-8663
NPI assigned
Mar 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Authorized official

Name
David Clark
Title
Ceo
Phone
(636) 227-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

511 Wilson Ave NW Ste E
Grand Rapids, MI 49534-7986

Mailing address

511 Wilson Ave NW
Grand Rapids, MI 49534-7986
Phone (616) 301-8663

Other names 1

  • Michigan Optical Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Grand Rapids Opticians LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1336849074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 WILSON AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347986",
            "telephone_number": "616-301-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 WILSON AVE NW STE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347986",
            "telephone_number": "616-301-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRO OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "636-227-2600"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michigan Optical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.