Jon Christopher Vanwagnen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004725 Issued in MI

Practice address

137 Parker Ave
Alpena, MI 49707-1413

Phone

(989) 916-6168

NPI assigned

Jul 9, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Charlevoix Eye Center, P.C.

  • Optometrist
  • Charlevoix, MI
  • NPI 1619315926
  Medicare reassignment NPD Authorized official
• Robert & Kimberly Molter Inc

  • Optometrist
  • Kalkaska, MI
  • NPI 1841303153
  NPD (past)
• Robert & Kimberly Molter Inc

  • Optometrist
  • Charlevoix, MI
  • NPI 1962528844
  NPD (past)

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1376808071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 PARKER AVE",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071413",
            "telephone_number": "989-916-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 PARKER AVE",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071413",
            "telephone_number": "989-916-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWAGNEN",
        "first_name": "JON",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usv Optical Inc.
• Frank Jacques Van Goethem, MA, LLP, LMSW
• James F Van Wagnen, OD
• David S. Vanderlinde, O.D.
• Tiffany Ann Vanschagen, M.A., CCC-SLP
• James L Vedder, DDS MS
• Rachel Marie Vercnocke
• Erin Vogelheim
• Steven E Vorenkamp, MD
• Lorie Jean Vorraro, D.C.

• Optometrist in Alpena, MI
• Providers in Alpena, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.