NPIMap

Organization Active NPI

Goodwill Optical Inc

Doing business as Goodwill Optical

  • Optometrist
  • Grand Rapids, MI
National Provider Identifier
1508034711
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GOODWILL OPTICAL INC
Doing business as
Goodwill Optical
Practice address
1655 4 Mile Rd NE
Grand Rapids, MI 49525-2438
Phone
(616) 447-0489
Fax
(616) 447-2283
NPI assigned
Feb 11, 2008
Last updated
Feb 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Timothy D Westra
Title
President
Phone
(616) 846-0620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1655 4 Mile Rd NE
Grand Rapids, MI 49525-2438

Mailing address

105 W Exchange St
Spring Lake, MI 49456-2024
Phone (616) 846-0620

Other names 1

  • Goodwill Optical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Goodwill Optical15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

1655 4 Mile Rd NE
Grand Rapids, MI 49525
Phone (616) 447-0489

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1508034711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W EXCHANGE ST",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494562024",
            "telephone_number": "616-846-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 4 MILE RD NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252438",
            "telephone_number": "616-447-0489",
            "fax_number": "616-447-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "WESTRA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-846-0620"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodwill Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

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