Dr Marie Fox PLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004197 Issued in MI

Legal business name

DR MARIE FOX PLC

Doing business as

Kalamazoo Valley Eyecare

Practice address

4855 W Centre Ave
Suite B
Portage, MI 49024-4686

Phone

(269) 375-3937

Fax

(269) 375-3938

NPI assigned

Jun 21, 2011

Last updated

May 12, 2012By 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. Marie L Fox, O.D.

Title

Owner/Optometrist

Phone

(269) 375-3937

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Kalamazoo Valley Eyecare Doing business as

Locations

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336780800000",
    "number": "1568758209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 W CENTRE AVE",
            "address_2": "SUITE B",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244686",
            "telephone_number": "269-375-3937",
            "fax_number": "269-375-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 W CENTRE AVE",
            "address_2": "SUITE B",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244686",
            "telephone_number": "269-375-3937",
            "fax_number": "269-375-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARIE FOX PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-21",
        "last_updated": "2012-05-12",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "269-375-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0C90369",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP PROVIDER NUMBER",
            "identifier": "200000030622",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568758209",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0C90390",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kalamazoo Valley Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Portage, MI
• Providers in Portage, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2012; 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.