Active NPI
Ranald Mackenzie, OD
- Optometrist
- Madison HTS, MI
National Provider Identifier
1669412854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- RM002595
- Practice address
- 655 W 13 Mile Rd
Madison HTS, MI 48071-1844 - Phone
- (248) 577-3659
- Fax
- (248) 588-9320
- NPI assigned
- Jun 7, 2006
- Last updated
- Mar 11, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | RM002595 | MI | Primary |
Addresses
Primary practice location
655 W 13 Mile Rd
Madison HTS, MI 48071-1844
Mailing address
32600 Gratiot Ave
Roseville, MI 48066-1126
Phone (586) 294-0120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RM002595 | MI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394496000000",
"number": "1669412854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32600 GRATIOT AVE",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480661126",
"telephone_number": "586-294-0120",
"fax_number": "586-294-6322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 W 13 MILE RD",
"city": "MADISON HTS",
"state": "MI",
"postal_code": "480711844",
"telephone_number": "248-577-3659",
"fax_number": "248-588-9320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKENZIE",
"first_name": "RANALD",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2014-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "RM002595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison HTS, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.