John S Graves OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003143 Issued in MI

Legal business name

JOHN S GRAVES OD PC

Practice address

105 N Grove St
Standish, MI 48658-2508

Phone

(989) 846-4197

Fax

(989) 846-4989

NPI assigned

Mar 8, 2016

Organization subpart

No

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

Authorized official

Name

Dr. John S Graves, ODNPI 1801875521

Title

Owner

Phone

(989) 846-4197

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• John S Graves, O.D. PC

  • Optometrist
  • Standish, MI
  • NPI 1801875521

  MI, Optometrist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1801257522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576",
            "city": "STANDISH",
            "state": "MI",
            "postal_code": "486580576",
            "telephone_number": "989-846-4197",
            "fax_number": "989-846-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N GROVE ST",
            "city": "STANDISH",
            "state": "MI",
            "postal_code": "486582508",
            "telephone_number": "989-846-4197",
            "fax_number": "989-846-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN S GRAVES OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-846-4197",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900Z60027",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda Lee Hawley, FNP-C
• Amanda M Hesling
• Mandi Lynn Hunt
• Intelicare Hospice Services, LLC
• Susan Elizabeth Jock, NP
• John S Graves OD PLC
• Keri Ann Marie Johnson
• Amber Ann Jones
• Miechon Jordan
• Dana R Katterman

• All providers in Standish, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.