Active NPI
David J. Scholten, O.D.
- Corneal and Contact Management Optometrist
- Kentwood, MI
National Provider Identifier
1477625168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 4901002566
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 900D16575 | Other | MI | BLUE CROSS/BLUE SHIELD OF MI |
| 4350446 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4901002566 | MI | MD | Corneal 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.