Active NPI
Gro Optical, LLC
Doing business as Grand Rapids Opticians, LLC
- Eyewear Supplier
- Ionia, MI
National Provider Identifier
1700917440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- GRO OPTICAL, LLC
- Doing business as
- G.R.O. Optical LLC
GRO Optical, LLC - Practice address
- 537 W Main St
Ionia, MI 48846-1652 - Phone
- (616) 523-2020
- Fax
- (616) 527-3756
- NPI assigned
- Mar 7, 2007
- Last updated
- Feb 15, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kelly McCrann
- Title
- Ceo
- Phone
- (636) 227-2600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
537 W Main St
Ionia, MI 48846-1652
Mailing address
750 E Beltline Ave NE
Grand Rapids, MI 49525-6049
Phone (616) 942-1350
Other names 3
- G.R.O. Optical LLC
- GRO Optical, LLC
- Grand Rapids Opticians, LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930067748 | MI | DME Supplier - Physician - Optometrist | 5193842128 | Practice locations: Ionia, MI |
Other NPIs with the same Medicare PAC ID 7
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Grand Rapids Opticians, LLC
- Eyewear Supplier
- Holland, MI
- NPI 1487785135
5193842128
-
dba Grand Rapids Opticians, LLC
- Eyewear Supplier
- Rockford, MI
- NPI 1780093716
5193842128
-
dba Grand Rapids Opticians, LLC
- Eyewear Supplier
- Grandville, MI
- NPI 1821129552
5193842128
National Provider Directory
National Provider Directory- Tax ID family
- Grand Rapids Opticians LLC
Other organizations with this tax ID 10
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1613347200000",
"number": "1700917440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 E BELTLINE AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495256049",
"telephone_number": "616-942-1350",
"fax_number": "616-949-1670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "537 W MAIN ST",
"city": "IONIA",
"state": "MI",
"postal_code": "488461652",
"telephone_number": "616-523-2020",
"fax_number": "616-527-3756"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRO OPTICAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-07",
"last_updated": "2021-02-15",
"certification_date": "2021-02-15",
"status": "A",
"authorized_official_last_name": "MCCRANN",
"authorized_official_first_name": "KELLY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "636-227-2600",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "G.R.O. Optical LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "GRO Optical, LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Grand Rapids Opticians, LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Grand Rapids Opticians, LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Ionia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.