Organization Active NPI

Krystal Kempf Eye Care PLLC

  • Optometrist
  • Portland, MI
National Provider Identifier
1649706847
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004448 Issued in MI
Legal business name
KRYSTAL KEMPF EYE CARE PLLC
Practice address
1311 E Bridge St
Portland, MI 48875-1601
Phone
(517) 647-7515
Fax
(517) 647-5445
NPI assigned
May 8, 2017
Last updated
May 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Authorized official

Name
Dr. Krystal K Andrews, O.D.NPI 1851583934
Title
Optometrist/Owner
Phone
(517) 927-2712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004448 MI Primary

Addresses

Primary practice location

1311 E Bridge St
Portland, MI 48875-1601

Mailing address

2914 Amherst Dr
Lansing, MI 48906-2401
Phone (517) 927-2712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180403000246 MI Part B Supplier - Clinic/Group Practice 6204191067 Receives reassigned benefits from 2 practitioners
Practice locations: Portland, MI

National Provider Directory

National Provider Directory

Locations

1311 E Bridge St
Portland, MI 48875
Phone (517) 647-7515

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1494201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1649706847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 AMHERST DR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489062401",
            "telephone_number": "517-927-2712",
            "fax_number": "517-647-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 E BRIDGE ST",
            "city": "PORTLAND",
            "state": "MI",
            "postal_code": "488751601",
            "telephone_number": "517-647-7515",
            "fax_number": "517-647-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRYSTAL KEMPF EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-08",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "517-927-2712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.