Individual provider Active NPI

Kirsten Donnellon, O.D.

  • Optometrist
  • Linden, MI
National Provider Identifier
1376771410
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004554 Issued in MI
Practice address
123 E Broad St
Linden, MI 48451-9126
Phone
(810) 735-9988
Fax
(810) 458-6575
NPI assigned
Jun 28, 2009
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1558 SC
Optometrist 152W00000X 4901004554 MI Primary

Addresses

Primary practice location

123 E Broad St
Linden, MI 48451-9126

Mailing address

89 S Washington St
Oxford, MI 48371-4979
Phone (248) 628-3441

Other practice location 1

2222 W Grand River Ave Ste A
Okemos, MI 48864-1604
Phone (248) 733-4433

Other identifiers 1

IdentifierTypeStateIssuer
1376771410MedicaidMI

Other names 1

  • Kirsten Harwood Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131003000296 MI Practitioner - Optometry 3476690371 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2222 W Grand River Ave
Suite a
Okemos, MI 48864-1604
Phone (248) 733-4433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1558SCMDClinical Psychologist
4901004554MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Oxford, PLLC Optometrist CurrentSince May 17, 2025 Accepting new patients
Voyage Eye Care PLLC Optometrist CurrentSince Nov 14, 2024 Accepting new patients
DRS Walton & Becker Eyecare PC Optometrist CurrentSince May 17, 2025 Accepting new patients
Eye Care Associates of SC LLC Optometrist Past Accepting new patients
Ocean Eye, PC Optometrist PastSince Sep 22, 2007 Accepting new patients

Locations

2222 W Grand River Ave
Ste A
Okemos, MI 48864
Phone (734) 602-4635

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1246147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1376771410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 S WASHINGTON ST",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483714979",
            "telephone_number": "248-628-3441",
            "fax_number": "248-628-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E BROAD ST",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484519126",
            "telephone_number": "810-735-9988",
            "fax_number": "810-458-6575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 W Grand River Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488641604",
            "country_code": "US",
            "telephone_number": "248-733-4433",
            "fax_number": "810-775-5338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLON",
        "first_name": "KIRSTEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1558",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376771410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "HARWOOD",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Linden, MI

Sources for this page

Verify at the official NPI Registry.