Organization Active NPI

Nichols Optical Inc

  • Eyewear Supplier
  • Mt Pleasant, MI
National Provider Identifier
1699725119
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
NICHOLS OPTICAL INC
Doing business as
Pearle Vision 8491
Practice address
4164 E Bluegrass Rd
Mt Pleasant, MI 48858-7967
Phone
(989) 772-9481
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Authorized official

Name
Ms. Lori Wirth
Title
General Manager
Phone
(231) 941-7788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

4164 E Bluegrass Rd
Mt Pleasant, MI 48858-7967

Mailing address

3200 S Airport Rd W
Suite 146
Traverse City, MI 49684-8117
Phone (231) 941-7788

Other identifiers 1

IdentifierTypeStateIssuer
864472126MedicaidMI

Other names 1

  • Pearle Vision 8491 Doing business as

National Provider Directory

National Provider Directory

Locations

4164 E Blue Grass Rd
Mt Pleasant, MI 48858
Phone (989) 772-9481

Practitioners & affiliated clinicians

Practitioners 4

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": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1699725119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S AIRPORT RD W",
            "address_2": "SUITE 146",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848117",
            "telephone_number": "231-941-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4164 E BLUEGRASS RD",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488587967",
            "telephone_number": "989-772-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLS OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-07-29",
        "status": "A",
        "authorized_official_last_name": "WIRTH",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "231-941-7788",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "864472126",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision 8491",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.