NPIMap

Organization Active NPI

Colburn Family Eyecare, PLLC

  • Optometrist
  • Grand Rapids, MI
National Provider Identifier
1659084283
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
COLBURN FAMILY EYECARE, PLLC
Practice address
5859 28TH Street SE
Grand Rapids, MI 49546-4954
Phone
(616) 949-5125
Fax
(616) 949-5843
NPI assigned
Dec 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Authorized official

Name
Dr. Rebecca J Colburn, ODNPI 1558464537
Title
Owner
Phone
(616) 724-7641

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

5859 28TH Street SE
Grand Rapids, MI 49546-4954

Mailing address

10260 Jordan River Dr SE
Alto, MI 49302-9189
Phone (616) 724-7641

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1659084283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 JORDAN RIVER DR SE",
            "city": "ALTO",
            "state": "MI",
            "postal_code": "493029189",
            "telephone_number": "616-724-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5859 28TH STREET SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495464954",
            "telephone_number": "616-949-5125",
            "fax_number": "616-949-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLBURN FAMILY EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-28",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "COLBURN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-724-7641",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.