Goodrich Optical Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

GOODRICH OPTICAL INC

Practice address

6425 S Pennsylvania Ave Ste 13
Lansing, MI 48911-5975

Phone

(517) 393-2660

Fax

(517) 393-1313

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David S Goodrich, ABOM

Title

Cio

Phone

(517) 393-2660

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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

• David Michael Bosak, O.D.

  • Optometrist
  • Lansing, MI
  • NPI 1194988790
  Medicare reassignment NPD
• Craig Douglas Perry, O.D.

  • Optometrist
  • North Chesterfield, VA
  • NPI 1063567816
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569888000000",
    "number": "1811095680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 DELHI COMMERCE DR STE 1",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488422193",
            "telephone_number": "517-393-2660",
            "fax_number": "517-393-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 S PENNSYLVANIA AVE STE 13",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489115975",
            "telephone_number": "517-393-2660",
            "fax_number": "517-393-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODRICH OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-10-01",
        "status": "A",
        "authorized_official_last_name": "GOODRICH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "517-393-2660",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ABOM"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "22-00278",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP FAMILY CARE",
            "identifier": "22-70051",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MICHIGAN",
            "identifier": "900C313260",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "OP0850",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gena Gonzalez, OTD, OTR/L
• Stephanie Ann Gonzalez, LCSW
• Elizabeth Anne Goodland, CSW
• Kaitlin Lauren Goodman, LMSW
• Kathryn Elen Goodman
• Kaleen Goodrich
• Emily Goodson, LMSW
• Ashton Sonet Goodwin, OTRL
• David J Goodyear
• Patricia Kelley Goorin, CRNA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.