Organization Active NPI

Pearle Vision Inc

  • Optometrist
  • Detroit, MI
National Provider Identifier
1508911397
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PEARLE VISION INC
Practice address
15631 Grand River Ave
Detroit, MI 48227-2281
Phone
(313) 273-3860
Fax
(248) 273-5070
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Wendy Uhls
Title
Medicare Supervisor
Phone
(513) 765-3534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

15631 Grand River Ave
Detroit, MI 48227-2281

Mailing address

15631 Grand River Ave
Detroit, MI 48227-2281
Phone (313) 273-3860

Other identifiers 1

IdentifierTypeStateIssuer
5017065MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508911397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15631 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272281",
            "telephone_number": "313-273-3860",
            "fax_number": "248-273-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15631 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272281",
            "telephone_number": "313-273-3860",
            "fax_number": "248-273-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARLE VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UHLS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "MEDICARE SUPERVISOR",
        "authorized_official_telephone_number": "513-765-3534"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5017065",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.