Myeyedr Optometry of Michigan, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MYEYEDR OPTOMETRY OF MICHIGAN, LLC

Doing business as

RX Optical

Practice address

6123 S Westnedge Ave
Portage, MI 49002-2811

Phone

(269) 327-7079

Fax

(269) 327-7165

NPI assigned

Mar 16, 2021

Organization subpart

No

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

Authorized official

Name

Sue Downes

Title

Secretary

Phone

(703) 847-8899

Specialties & licenses 1

Addresses

Other names 1

• RX Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew A Parker, O.D.

  • Optometrist
  • Portage, MI
  • NPI 1770647505
  NPD

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1790360220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6123 S WESTNEDGE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490022811",
            "telephone_number": "269-327-7079",
            "fax_number": "269-327-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF MICHIGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "DOWNES",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RX Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RX Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia Kay Musser, RN
• Erin Marie Muszynski, L.AC
• Remnant Mwanahiba, MD
• Kennedy Opiyo Mwanda
• Brett Andrew Myers, DC
• Myndfull Care Management Michigan PC
• Myndfull Care Michigan PC
• Nadine Fish Inc
• Paula Rose Nagy
• Sydney Nardizzi

• Optometrist in Portage, MI
• Providers in Portage, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.

Verify at the official NPI Registry.