Organization Active NPI

RX Optical Laboratories, Inc.

  • Optometrist
  • Jenison, MI
National Provider Identifier
1487711214
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
RX OPTICAL LABORATORIES, INC.
Practice address
304 Baldwin St
Jenison, MI 49428-7909
Phone
(616) 457-4443
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Authorized official

Name
Stephan Jepson
Title
President
Phone
(269) 342-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

304 Baldwin St
Jenison, MI 49428-7909

Mailing address

1825 S Park St
Kalamazoo, MI 49001-2759

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1487711214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 S PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490012759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287909",
            "telephone_number": "616-457-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RX OPTICAL LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "JEPSON",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-342-0003"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.