Allendale Family Vision LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004659 Issued in MI

Legal business name

ALLENDALE FAMILY VISION LLC

Practice address

6101 Lake Michigan Dr
Allendale, MI 49401-9215

Phone

(616) 895-2020

Fax

(616) 895-2060

NPI assigned

Jul 20, 2011

Last updated

May 2, 2013By 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. Nicholas Vijay Lillie, O.D.NPI 1053609693

Title

President

Phone

(616) 895-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas Vijay Lillie, O.D.

  • Optometrist
  • Allendale, MI
  • NPI 1053609693
  Medicare reassignment Care Compare group NPD Authorized official
• Amanda Bancroft

  • Optometrist
  • Marion, VA
  • NPI 1073139416

  MI

  Medicare reassignment Care Compare group NPD
• Kody Michael Drewer

  • Optometrist
  • Allendale, MI
  • NPI 1578490306
  Medicare reassignment

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1639467962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 LAKE MICHIGAN DR",
            "address_2": "STE B700",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019215",
            "telephone_number": "616-895-2020",
            "fax_number": "616-895-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 LAKE MICHIGAN DR",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019215",
            "telephone_number": "616-895-2020",
            "fax_number": "616-895-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLENDALE FAMILY VISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "LILLIE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "VIJAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-895-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Agrusa
• Elizabeth L Albright, DO
• Laylah Ali
• Allendale Eye Care, LLC
• Allendale Family Practice
• Jessica Altman, LMT
• Megan Alwardt, PT, DPT
• American Hearing Centers, LLC (Sonus Sf0005)
• Meghann Noelle Antes
• Atrium Allendale LLC (Allendale Nursing and Rehabilitation Community)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.