NPIMap

Organization Active NPI

Primary Vision Center

  • Optometrist
  • Sandusky, MI
National Provider Identifier
1568642957
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002288 Issued in MI
Legal business name
PRIMARY VISION CENTER
Practice address
33 W Sanilac Rd
Sandusky, MI 48471-1036
Phone
(810) 648-4242
Fax
(810) 648-4248
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Dr. George William McNiven, OD
Title
President
Phone
(810) 648-4242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901002288 MI Primary

Addresses

Primary practice location

33 W Sanilac Rd
Sandusky, MI 48471-1036

Mailing address

33 W Sanilac Rd
PO Box 112
Sandusky, MI 48471-1036
Phone (810) 648-4242

Other identifiers 1

IdentifierTypeStateIssuer
900G665050OtherMIBCBS OF MI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1568642957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W SANILAC RD",
            "address_2": "PO BOX 112",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711036",
            "telephone_number": "810-648-4242",
            "fax_number": "810-648-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W SANILAC RD",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711036",
            "telephone_number": "810-648-4242",
            "fax_number": "810-648-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "MCNIVEN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-648-4242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "900G665050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.