Academy of Vision Development, PLLC

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

4901004369 Issued in MI

Legal business name

ACADEMY OF VISION DEVELOPMENT, PLLC

Doing business as

Avd

Practice address

6617 Crossings Dr SE
Suite 102
Grand Rapids, MI 49508-7378

Phone

(616) 541-7080

Fax

(616) 541-7088

NPI assigned

Feb 5, 2016

Last updated

Feb 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Angela L Sanders, OD

Title

Sole Owner/Member

Phone

(616) 485-9804

Specialties & licenses 1

Addresses

Other names 1

• AVD Doing business as

Locations

Practitioners 1

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.

• Angela Lynn Martin, OD

  • Vision Therapy Optometrist
  • Grand Rapids, MI
  • NPI 1598875049
  NPD (past)

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1548628415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6617 CROSSINGS DR SE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087378",
            "telephone_number": "616-541-7080",
            "fax_number": "616-541-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6617 CROSSINGS DR SE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087378",
            "telephone_number": "616-541-7080",
            "fax_number": "616-541-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMY OF VISION DEVELOPMENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SOLE OWNER/MEMBER",
        "authorized_official_telephone_number": "616-485-9804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MI",
            "license": "4901004369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vision Therapy Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Vision Therapy Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.