Marie Louise Fox, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004197 Issued in MI

Practice address

6101 Newport Rd
Ste a
Portage, MI 49002-9233

Phone

(269) 382-6500

Fax

(269) 382-2286

NPI assigned

Oct 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• State of Michigan Office of Financial Management

  • Psychiatric Hospital
  • Westland, MI
  • NPI 1508883299
  Medicare reassignment NPD
• State of Michigan Office of Financial Management

  • Psychiatric Hospital
  • Kalamazoo, MI
  • NPI 1194736587
  NPD
• State of Michigan Office of Financial Management

  • Skilled Nursing Facility
  • Chesterfield, MI
  • NPI 1497342653
  NPD
• Kalamazoo Optometry PC

  • Optometrist
  • Portage, MI
  • NPI 1417148669
  NPD (past)

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1790773646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 NEWPORT RD",
            "address_2": "STE A",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490029233",
            "telephone_number": "269-382-6500",
            "fax_number": "269-382-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 NEWPORT RD",
            "address_2": "STE A",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490029233",
            "telephone_number": "269-382-6500",
            "fax_number": "269-382-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "MARIE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2010-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "381734365",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4901004197",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "17800",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900C947460",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC,IBA,PHP",
            "identifier": "2230146",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4536386",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fountain View of Portage
• Cole Fournier
• Dawn Renae Fox, FNP-C
• Julianne Fox
• Letetsia Fox, PHD
• Kaela Rae Frailing, PT, DPT
• Katherine Frailing, OTR/L
• Kimberley Anne Franke, PHARM.D.
• Ayanna Frazier
• Sarah Frederick, MSW

• 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 Apr 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.