Direct Optical of Canton, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

DIRECT OPTICAL OF CANTON, LLC

Practice address

41840 Ford Road
Canton, MI 48187

Phone

(734) 981-1760

Fax

(734) 981-1574

NPI assigned

Oct 18, 2010

Organization subpart

Yes

Parent organization

DIRECT OPTICAL, INCAs reported in NPPES

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

Authorized official

Name

Ms. Mariana Mihajlovski

Title

President

Phone

(734) 981-1760

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Part of

DM Co

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tiansa Karana, OD

  • Optometrist
  • Livonia, MI
  • NPI 1821530403
  Medicare reassignment NPD
• Jamie Lynn McKenzie, O.D.

  • Optometrist
  • Haslett, MI
  • NPI 1306152582
  Medicare reassignment NPD

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1598075160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41840 FORD ROAD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48187",
            "telephone_number": "734-981-1760",
            "fax_number": "734-981-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41840 FORD ROAD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48187",
            "telephone_number": "734-981-1760",
            "fax_number": "734-981-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT OPTICAL OF CANTON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIRECT OPTICAL, INC",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "MIHAJLOVSKI",
        "authorized_official_first_name": "MARIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-981-1760",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA VISION",
            "identifier": "NONE",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MECA",
            "identifier": "NONE",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION CARE",
            "identifier": "CP2724",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEBS",
            "identifier": "NONE",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL VISION ADMINISTRATORS",
            "identifier": "230266",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "900F376990",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR VISION",
            "identifier": "NONE",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "58695",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin M Dickinson, MS, RD
• Stacy Lynn Dickinson, BSW
• Natalia Diiacovo
• Amber M Dillon, LMSW, LCSW
• Patricia Dimaria
• Divine Arrival LLC
• Divinecare Home Health Care
• Darlene Voncille Dixon-Hall, RN
• Angela Dlubacz, M.ED., AT, CADC
• DMC Billing Associates LLC

• Eyewear Supplier in Canton, MI
• Providers in Canton, MI by specialty
• Eyewear Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.