Design 309 LLC,

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

DESIGN 309 LLC,

Practice address

7609 Brockway Rd
Brockway, MI 48097-3459

Phone

(810) 387-9333

Fax

(810) 387-9020

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Catherine Anne Bedy

Title

General Manager

Phone

(810) 387-9333

Specialties & licenses 1

Addresses

Other names 1

• Great Lakes Vision Center Doing business as

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

• Heidi Marie McCullah, O.D.

  • Optometrist
  • Fort Gratiot, MI
  • NPI 1538164728
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457439416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7609 BROCKWAY RD",
            "city": "BROCKWAY",
            "state": "MI",
            "postal_code": "480973459",
            "telephone_number": "810-387-9333",
            "fax_number": "810-387-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7609 BROCKWAY RD",
            "city": "BROCKWAY",
            "state": "MI",
            "postal_code": "480973459",
            "telephone_number": "810-387-9333",
            "fax_number": "810-387-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIGN 309 LLC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEDY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "810-387-9333",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Louise Brosius
• Madisyn Burks
• Kathleen Hurst Chmielewski, DDS
• Dreama K Closser
• Kathleen Diane Coenen, P.A.
• Tara R Deters, PA-C
• Detroit Vamc
• Tyler James Drabant, DPT
• Edgerton Chiropractic Clinic Inc
• Brent Lee Edgerton, DC

• All providers in Brockway, MI
• Optician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.