Stadium Opticians, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003645 Issued in MI

Legal business name

STADIUM OPTICIANS, INC.

Practice address

2333 W Stadium Blvd
Ann Arbor, MI 48103-3844

Phone

(734) 663-0870

Fax

(734) 761-5242

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Charles R. Meldrum, OPTICIAN

Title

President

Phone

(734) 663-0870

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Stadium Opticians Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Stadium Opticians, Inc.

  • Optometrist
  • Ann Arbor, MI
  • NPI 1245384544
  NPD tax ID
• Stadium Opticians, Inc.

  • Optician
  • Ann Arbor, MI
  • NPI 1851443766
  NPD tax ID

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467584169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 W STADIUM BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481033844",
            "telephone_number": "734-663-0870",
            "fax_number": "734-761-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 W STADIUM BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481033844",
            "telephone_number": "734-663-0870",
            "fax_number": "734-761-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STADIUM OPTICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MELDRUM",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-663-0870",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "7346630870",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Charles Stacey, MD
• Casey J Stach, M.A.
• Michael Stack, EP
• John Joseph Stacy, MLTDSW, CAC-1
• Stadium Opticians, Inc.
• Stadium Opticians, Inc.
• Leonard Louis Stadtmiller, R.PH.
• Emma Stafne
• Alisa W. Stager, PA
• Brian Craig Stagg, M.D.

• Optometrist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Optometrist 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.