NPIMap

Organization Active NPI

Wyoming Family Vision Care LLC

Doing business as Wyoming Family Vision Care

  • Optometrist
  • Wyoming, MI
National Provider Identifier
1730583972
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004759 Issued in MI
Legal business name
WYOMING FAMILY VISION CARE LLC
Doing business as
Wyoming Family Vision Care
Practice address
1391 36TH St SW
Wyoming, MI 49509-3417
Phone
(616) 538-5420
Fax
(616) 538-7288
NPI assigned
Oct 17, 2014
Last updated
Oct 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Mrs. Laura Crispina Reyes
Title
Optician
Phone
(616) 538-5420

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004597 MI
Optometrist 152W00000X 4901004759 MI Primary

Addresses

Primary practice location

1391 36TH St SW
Wyoming, MI 49509-3417

Mailing address

1391 36TH St SW
Wyoming, MI 49509-3417
Phone (616) 538-5420

Other names 1

  • Wyoming Family Vision Care Doing business as

National Provider Directory

National Provider Directory

Locations

1391 36th St SW
Wyoming, MI 49509
Phone (616) 538-5420

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1730583972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 36TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495093417",
            "telephone_number": "616-538-5420",
            "fax_number": "616-538-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1391 36TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495093417",
            "telephone_number": "616-538-5420",
            "fax_number": "616-538-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING FAMILY VISION CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "CRISPINA",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "616-538-5420",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004597",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyoming Family Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.