Angela Lynn Martin, OD

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

4901004369 Issued in MI

Practice address

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

Phone

(616) 541-7080

Fax

(616) 541-7088

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Angela Lynn Sanders Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Academy of Vision Development, PLLC

  • Vision Therapy Optometrist
  • Grand Rapids, MI
  • NPI 1548628415
  NPD (past)
• Aeg Michigan Professional LLC

  • Optometrist
  • Chesaning, MI
  • NPI 1053032912
  NPD (past)
• Okemos Optometry,PC

  • Optometrist
  • Okemos, MI
  • NPI 1750491213
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1598875049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6617 CROSSINGS DR SE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087378",
            "telephone_number": "616-485-9804",
            "fax_number": "616-541-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6617 CROSSINGS DR SE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087378",
            "telephone_number": "616-541-7080",
            "fax_number": "616-541-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANGELA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004369",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MI",
            "license": "4901004369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "SANDERS",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alex Robert Martin, D.O.
• Alexander Martin
• Amanda Martin, LMSW
• Andrea L Martin, LMSW
• Angela Denese Martin, LPN
• Ausar Martin
• Camilla J. Martin, LMSW
• Cheryl Martin
• Christie Martin, LPC
• Christine Suzanne Martin, PAC

• 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 May 16, 2022; 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.