Organization Active NPI

Kensington Ophthalmology PLC

  • Ophthalmology Physician
  • Brighton, MI
National Provider Identifier
1821026493
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301055985 Issued in MI
Legal business name
KENSINGTON OPHTHALMOLOGY PLC
Practice address
10201 Grand River Rd
Brighton, MI 48116-9591
Phone
(810) 229-3363
Fax
(810) 229-5532
NPI assigned
Jun 30, 2006
Last updated
Apr 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Authorized official

Name
Dr. Holly Holm, MDNPI 1114989035
Title
Owner
Phone
(810) 229-3363

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 4301055985 MI Primary

Addresses

Primary practice location

10201 Grand River Rd
Brighton, MI 48116-9591

Mailing address

10201 Grand River Rd
Brighton, MI 48116-9591
Phone (810) 229-3363

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071005000741 MI Part B Supplier - Clinic/Group Practice 2769577683 Receives reassigned benefits from 4 practitioners
Practice locations: Brighton, MI

National Provider Directory

National Provider Directory

Locations

10201 Grand River Rd
Brighton, MI 48116
Phone (810) 229-3363

3901 W 13 Mile Rd
Royal Oak, MI 48073

3901 W 13 Mile Rd
Royal Oak, MI 48073

Practitioners & affiliated clinicians

Practitioners 4

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": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1821026493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 GRAND RIVER RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481169591",
            "telephone_number": "810-229-3363",
            "fax_number": "810-229-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 GRAND RIVER RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481169591",
            "telephone_number": "810-229-3363",
            "fax_number": "810-229-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENSINGTON OPHTHALMOLOGY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-229-3363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301055985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.