NPIMap

Organization Active NPI

Lansing Ophthalmology, PC

  • Ophthalmology Physician
  • Lake Odessa, MI
National Provider Identifier
1851423263
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LANSING OPHTHALMOLOGY, PC
Practice address
1170 Jordan Lake St
Lake Odessa, MI 48849-1212
Phone
(517) 337-0316
Fax
(517) 337-1779
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Donald Shook
Title
Executive Director
Phone
(517) 337-1899

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1170 Jordan Lake St
Lake Odessa, MI 48849-1212

Mailing address

1005 Charlevoix Dr Ste 100
Grand Ledge, MI 48837-8186
Phone (517) 337-1668

Other names 1

  • LO Eye Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lansing Ophthalmology PC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1170 Jordan Lake St
Lake Odessa, MI 48849
Phone (616) 374-3184

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1851423263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 CHARLEVOIX DR STE 100",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488378186",
            "telephone_number": "517-337-1668",
            "fax_number": "517-622-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 JORDAN LAKE ST",
            "city": "LAKE ODESSA",
            "state": "MI",
            "postal_code": "488491212",
            "telephone_number": "517-337-0316",
            "fax_number": "517-337-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANSING OPHTHALMOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "SHOOK",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "517-337-1899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LO Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Odessa, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.