Individual provider Active NPI

Kody Michael Drewer

  • Optometrist
  • Allendale, MI
National Provider Identifier
1578490306
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005951 Issued in MI
Practice address
11145 68TH Ave Ste C
Allendale, MI 49401-9738
Phone
(616) 300-2259
NPI assigned
May 6, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 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 4901005951 MI Primary

Addresses

Primary practice location

11145 68TH Ave Ste C
Allendale, MI 49401-9738

Mailing address

11145 68TH Ave Ste C
Allendale, MI 49401-9738
Phone (616) 300-2259

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
I20260618001184 MI Practitioner - Optometry 6800368044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11145 68TH Ave
Suite C
Allendale, MI 49401-9738

3768 Waterton Dr
Grandville, MI 49418-8612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1778025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1578490306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11145 68TH AVE STE C",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019738",
            "telephone_number": "616-300-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11145 68TH AVE STE C",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019738",
            "telephone_number": "616-300-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREWER",
        "first_name": "KODY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-06",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allendale, MI

Sources for this page

Verify at the official NPI Registry.