Individual provider Active NPI

John P. Hemming, O.D.

  • Optometrist
  • Lake Odessa, MI
National Provider Identifier
1497739643
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002697 Issued in MI
Practice address
1170 Jordan Lake St
Lake Odessa, MI 48849-1212
Phone
(616) 374-3284
Fax
(616) 374-2020
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002697 MI Primary

Addresses

Primary practice location

1170 Jordan Lake St
Lake Odessa, MI 48849-1212

Mailing address

2001 Coolidge Rd
East Lansing, MI 48823-1378
Phone (517) 337-1668

Other identifiers 5

IdentifierTypeStateIssuer
4487209MedicaidMI
P00174370OtherMIRAILROAD MEDICARE
200000002103OtherMIPHPMM
4487218MedicaidMI
JH002697OtherMISTATE LICENSE NUMBER

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
4901002697MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lo Optical, LLC PastSince Jul 18, 2003 Accepting new patients
Lansing Ophthalmology, P.C. Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1497739643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 COOLIDGE RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488231378",
            "telephone_number": "517-337-1668",
            "fax_number": "517-337-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 JORDAN LAKE ST",
            "city": "LAKE ODESSA",
            "state": "MI",
            "postal_code": "488491212",
            "telephone_number": "616-374-3284",
            "fax_number": "616-374-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMMING",
        "first_name": "JOHN",
        "middle_name": "P.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4487209",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00174370",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHPMM",
            "identifier": "200000002103",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4487218",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "JH002697",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Odessa, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.