Individual provider Active NPI

Morgan Ollinger

  • Optometrist
  • Big Rapids, MI
National Provider Identifier
1467907832
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005007 Issued in MI
Practice address
1124 S State St
Big Rapids, MI 49307-2256
Phone
(231) 591-2020
Fax
(231) 591-3991
NPI assigned
Aug 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005007 MI Primary

Addresses

Primary practice location

1124 S State St
Big Rapids, MI 49307-2256

Mailing address

1124 S State St
Big Rapids, MI 49307-2256
Phone (231) 591-2020

Other identifiers 2

IdentifierTypeStateIssuer
0E476020OtherMIBLUE CROSS
0784610001OtherMEDICARE DME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20171114002121 TN Practitioner - Optometry 4082902093 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern College of Optometry Optometrist CurrentSince Sep 22, 2017 Accepting new patients

Locations

1245 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

1350 Concourse Ave
Ste 264
Memphis, TN 38104
Phone (901) 252-3670

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1467907832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 S STATE ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072256",
            "telephone_number": "231-591-2020",
            "fax_number": "231-591-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 S STATE ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072256",
            "telephone_number": "231-591-2020",
            "fax_number": "231-591-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLLINGER",
        "first_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0E476020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0784610001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

Verify at the official NPI Registry.