Individual provider Active NPI

Korinne Marie Swain, O.D.

  • Optometrist
  • Muskegon, MI
National Provider Identifier
1720077845
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003090 Issued in MI
Practice address
1179 Whitehall Rd
Ste. B
Muskegon, MI 49445-2497
Phone
(231) 744-3573
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003090 MI Primary

Addresses

Primary practice location

1179 Whitehall Rd
Ste. B
Muskegon, MI 49445-2497

Mailing address

3359 Memorial Dr
Muskegon, MI 49445-2129
Phone (231) 744-1394

Other identifiers 2

IdentifierTypeStateIssuer
900F165250OtherMIBLUE CROSS & BLUE SHIELD
1806648MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100217000465 MI Practitioner - Optometry 3870637671 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Optometry LLC Optometrist CurrentSince Dec 13, 2007 Accepting new patients
Dennis & David Company Optometrist CurrentSince Jan 1, 2022 Accepting new patients

Locations

30150 Telegraph Rd
Ste 371
Bingham Farms, MI 48025
Phone (734) 493-1662

1179 Whitehall Rd
Ste B
North Muskegon, MI 49445
Phone (231) 744-3573

24293 Telegraph Rd
Ste 212
Southfield, MI 48033
Phone (517) 351-8377

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1720077845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 MEMORIAL DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494452129",
            "telephone_number": "231-744-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 WHITEHALL RD",
            "address_2": "STE. B",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494452497",
            "telephone_number": "231-744-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "KORINNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  & BLUE SHIELD",
            "identifier": "900F165250",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1806648",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.