Individual provider Active NPI

David J. Scholten, O.D.

  • Corneal and Contact Management Optometrist
  • Kentwood, MI
National Provider Identifier
1477625168
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
4901002566 Issued in MI
Practice address
2350 32ND St SE
Kentwood, MI 49508-7901
Phone
(616) 243-0007
Fax
(616) 243-0540
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 4901002566 MI Primary

Addresses

Primary practice location

2350 32ND St SE
Kentwood, MI 49508-7901

Mailing address

2350 32ND St SE
Kentwood, MI 49508-7901
Phone (616) 243-0007

Other identifiers 2

IdentifierTypeStateIssuer
900D16575OtherMIBLUE CROSS/BLUE SHIELD OF MI
4350446MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901002566MIMDCorneal and Contact Management Optometrist

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1477625168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 32ND ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087901",
            "telephone_number": "616-243-0007",
            "fax_number": "616-243-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 32ND ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087901",
            "telephone_number": "616-243-0007",
            "fax_number": "616-243-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLTEN",
        "first_name": "DAVID",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MI",
            "license": "4901002566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD OF MI",
            "identifier": "900D16575",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4350446",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.