Organization Active NPI

Livingston County Vision Center

Doing business as Eye Care One of Livingston County

  • Optometrist
  • Howell, MI
National Provider Identifier
1790953248
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004200 Issued in MI
Legal business name
LIVINGSTON COUNTY VISION CENTER
Doing business as
Eye Care One of Livingston County
Practice address
2674 E Grand River Ave
Howell, MI 48843-8544
Phone
(517) 546-9242
Fax
(517) 546-7840
NPI assigned
Feb 19, 2008
Last updated
May 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Authorized official

Name
Dr. Chad Robert Nixon, O.D.NPI 1205936838
Title
President/Owner
Phone
(517) 546-9242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901004200 MI Primary

Addresses

Primary practice location

2674 E Grand River Ave
Howell, MI 48843-8544

Mailing address

2674 E Grand River Ave
Howell, MI 48843-8544
Phone (517) 546-9242

Other identifiers 3

IdentifierTypeStateIssuer
4901004200OtherMISTATE LICENSE NUMBER
900D710770OtherMIBLUE CROSS BLUE SHIELD
4787760 TYPE 94MedicaidMI

Other names 1

  • Eye Care One of Livingston County Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041208000868 MI Part B Supplier - Clinic/Group Practice 8628034931 Receives reassigned benefits from 1 practitioner
Practice locations: Howell, MI

National Provider Directory

National Provider Directory

Locations

2674 E Grand River Ave
Howell, MI 48843
Phone (517) 546-9242

Practitioners & affiliated clinicians

Practitioners 2

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": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1790953248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2674 E GRAND RIVER AVE",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438544",
            "telephone_number": "517-546-9242",
            "fax_number": "517-546-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2674 E GRAND RIVER AVE",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488438544",
            "telephone_number": "517-546-9242",
            "fax_number": "517-546-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVINGSTON COUNTY VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "517-546-9242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "4901004200",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900D710770",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4787760 TYPE 94",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Care One of Livingston County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Howell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.