NPIMap

Organization Active NPI

Michigan Optical LLC

  • Eyewear Supplier
  • Grand Rapids, MI
National Provider Identifier
1447427919
Registry record updated May 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
045514 Issued in MI
Legal business name
MICHIGAN OPTICAL LLC
Practice address
511 Wilson Ave NW
Suite E
Grand Rapids, MI 49534-7986
Phone
(616) 301-8663
Fax
(616) 301-2987
NPI assigned
May 13, 2008
Last updated
May 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2009

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

Authorized official

Name
Mr. Douglas CramerNPI 1124168232
Title
Owner
Phone
(616) 301-8663

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
Eyewear Supplier 332H00000X 045514 MI Primary

Addresses

Primary practice location

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

Mailing address

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

National Provider Directory

National Provider Directory

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": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242345600000",
    "number": "1447427919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 WILSON AVE NW",
            "address_2": "SUITE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347986",
            "telephone_number": "616-301-8663",
            "fax_number": "616-301-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 WILSON AVE NW",
            "address_2": "SUITE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347986",
            "telephone_number": "616-301-8663",
            "fax_number": "616-301-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2009-05-15",
        "status": "A",
        "authorized_official_last_name": "CRAMER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-301-8663",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": "045514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 15, 2009; 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.