Sara Rose Bush, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004593 Issued in MI

Practice address

1124 S State St
Big Rapids, MI 49307-2256

Phone

(231) 591-2020

NPI assigned

Jul 21, 2010

Last updated

Feb 19, 2015By the provider in NPPES

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 1

Other names 1

• Dr. Sara Rose Pavlik Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Luxottica Retail North America Inc

  dba Lenscrafters #05578

  • Eyewear Supplier
  • Midland, MI
  • NPI 1053457101
  NPD (past)
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1821301763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 S STATE ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072256",
            "telephone_number": "231-591-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 S STATE ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072256",
            "telephone_number": "231-591-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "SARA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0E47602",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "PAVLIK",
            "middle_name": "ROSE",
            "prefix": "DR.",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heather Elizabeth Buist, OD
• Dwight Evan Bull, LMSW
• Marcia Kay Bull, MSW
• Meshelle L Burrows, LPC
• Jessica Buscaino
• Brenda L Byl, COTA
• Guiseppe Calandrino, DO
• Nicole Campbell, PHARMD
• Skylar Rose Campbell
• Theresa Canterbur, LBSW

• Optometrist in Big Rapids, MI
• Providers in Big Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.