Capital City Vision PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003644 Issued in MI

Legal business name

CAPITAL CITY VISION PC

Practice address

1865 W Grand River Ave
Okemos, MI 48864-1840

Phone

(517) 349-2393

Fax

(517) 349-3751

NPI assigned

Feb 12, 2008

Organization subpart

No

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

Authorized official

Name

Michelle Whitman

Title

Billing Specialist

Phone

(517) 349-2393

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Colleen Patricia Phillips, OD

  • Optometrist
  • Okemos, MI
  • NPI 1841266525
  Medicare reassignment NPD

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1871761965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 W GRAND RIVER AVE",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641840",
            "telephone_number": "517-349-2393",
            "fax_number": "517-349-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 W GRAND RIVER AVE",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641840",
            "telephone_number": "517-349-2393",
            "fax_number": "517-349-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL CITY VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "WHITMAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "517-349-2393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017331",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200000002532",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne E Campbell, NURSE PRACTITIONER
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• John Cantu, LLPC
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• Capital Foot & Ankle Centers, PC
• Capital Urological Associates Laboratory
• Jenna Card
• Care Connection Home Care Mi LLC
• Care Connections

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.