NPIMap

Organization Active NPI

West Michigan Contact Lens Specialists PLLC

  • Optometrist
  • Kentwood, MI
National Provider Identifier
1346963758
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WEST MICHIGAN CONTACT LENS SPECIALISTS PLLC
Practice address
4130 Breton Rd SE Ste a
Kentwood, MI 49512-3808
Phone
(616) 341-1713
NPI assigned
Sep 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Authorized official

Name
Dr. Adeline R Bauer, ODNPI 1891103818
Title
Owner Optometrist
Phone
(989) 906-7786

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary
Corneal and Contact Management OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WC0802X

Addresses

Primary practice location

4130 Breton Rd SE Ste a
Kentwood, MI 49512-3808

Mailing address

7719 Dream Isle Dr NE
Belding, MI 48809-9370
Phone (989) 906-7786

Other identifiers 1

IdentifierTypeStateIssuer
4901004841OtherMIOPTOMETRY LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

4130 Breton Rd SE
Ste A
Kentwood, MI 49512
Phone (616) 341-1713

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1346963758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7719 DREAM ISLE DR NE",
            "city": "BELDING",
            "state": "MI",
            "postal_code": "488099370",
            "telephone_number": "989-906-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 BRETON RD SE STE A",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495123808",
            "telephone_number": "616-341-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MICHIGAN CONTACT LENS SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "ADELINE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "989-906-7786",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE NUMBER",
            "identifier": "4901004841",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.