Organization Active NPI

Michael E. Klaich, O.D.

  • Optometrist
  • Grand Junction, CO
National Provider Identifier
1497927875
Registry record updated Jan 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1314 Issued in CO
Legal business name
MICHAEL E. KLAICH, O.D.
Practice address
1306 E Sherwood Dr
Grand Junction, CO 81501-7578
Phone
(970) 245-5678
Fax
(970) 245-5679
NPI assigned
Mar 26, 2008
Last updated
Jan 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2010

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

Authorized official

Name
Mrs. Lisa Lewellen
Title
Office Manager
Phone
(970) 245-5678

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1314 CO Primary

Addresses

Primary practice location

1306 E Sherwood Dr
Grand Junction, CO 81501-7578

Mailing address

1306 E Sherwood Dr
Grand Junction, CO 81501-7578
Phone (970) 245-5678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930017599 CO DME Supplier - Physician - Optometrist 5890852917 Practice locations: Grand Junction, CO

National Provider Directory

National Provider Directory

Locations

1306 E Sherwood Dr
Grand Junction, CO 81501
Phone (970) 243-8230

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262908800000",
    "number": "1497927875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 E SHERWOOD DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815017578",
            "telephone_number": "970-245-5678",
            "fax_number": "970-245-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 E SHERWOOD DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815017578",
            "telephone_number": "970-245-5678",
            "fax_number": "970-245-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E. KLAICH, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2010-01-08",
        "status": "A",
        "authorized_official_last_name": "LEWELLEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-245-5678",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.