Lauren Ewald

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005709 Issued in MI

Practice address

12606 Holly Rd
Grand Blanc, MI 48439-1892

Phone

(810) 694-3652

NPI assigned

Jun 9, 2023

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 names 1

• Laure Weidner Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holly Vision Clinic PCGroup PAC ID 4688919319, 3 clinicians

Grand Blanc Vision Clinic PCGroup PAC ID 9739119793, 4 clinicians

Iris Eyecare PCGroup PAC ID 9335478650, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Grand Blanc Vision Clinic P.C.

  • Optometrist
  • Grand Blanc, MI
  • NPI 1013135870
  Medicare reassignment Care Compare group NPD
• Holly Vision Clinic PC

  • Optometrist
  • Holly, MI
  • NPI 1316421308
  Medicare reassignment Care Compare group NPD
• Iris Eyecare PC

  • Optometrist
  • Fenton, MI
  • NPI 1881155281
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1841974037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15500 SILVER PKWY APT 202",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12606 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391892",
            "telephone_number": "810-694-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWALD",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURE",
            "last_name": "WEIDNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Evans
• Francesca Marie Evans
• Lance Evans
• Taylor Hope Evans
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• Excellent Care Physical Therapy & Wellness LLC
• Sabit Eyub, DO
• Zahraa Jalal Ezzat
• Karhonda Fails, LMSW
• Samir Faldu

• Optometrist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.