Individual provider Active NPI

Naomi Ann Pack-Cunningham, O.D.

  • Optometrist
  • Canton, MI
National Provider Identifier
1528016961
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003888 Issued in MI
Practice address
43271 Ford Rd
Canton, MI 48187-3340
Phone
(734) 981-8111
NPI assigned
May 5, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003888 MI Primary

Addresses

Primary practice location

43271 Ford Rd
Canton, MI 48187-3340

Mailing address

45744 Bryn Mawr Rd
Canton, MI 48187-5430
Phone (734) 454-1701

Other names 1

  • Dr. Naomi Ann Pack Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111006000617 MI Practitioner - Optometry 3072785468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SVS Vision IncGroup PAC ID 9931257110, 41 clinicians

Practice addresses (Care Compare)

6725 Park Ave
Allen Park, MI 48101-2033
Phone (313) 382-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901003888MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist CurrentSince Aug 19, 2020 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Aug 19, 2020 Accepting new patients

Locations

6725 Park Ave
Allen Park, MI 48101
Phone (313) 382-0100

118 Cass Ave
Mount Clemens, MI 48043
Phone (586) 464-1479

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528016961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45744 BRYN MAWR RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875430",
            "telephone_number": "734-454-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43271 FORD RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873340",
            "telephone_number": "734-981-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK-CUNNINGHAM",
        "first_name": "NAOMI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAOMI",
            "last_name": "PACK",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.