Organization Active NPI

Lake Orion Vision PC

  • Optometrist
  • Lake Orion, MI
National Provider Identifier
1881072494
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LAKE ORION VISION PC
Practice address
81 Indianwood Rd
Lake Orion, MI 48362-1595
Phone
(248) 693-2321
NPI assigned
May 14, 2015
Last updated
Jul 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Authorized official

Name
Dr. Tiffany ZairNPI 1679887814
Title
Optometrist/Owner
Phone
(248) 693-2321

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
Optometrist 152W00000X MI Primary

Addresses

Primary practice location

81 Indianwood Rd
Lake Orion, MI 48362-1595

Mailing address

81 Indianwood Rd
Lake Orion, MI 48362-1595

Other identifiers 2

IdentifierTypeStateIssuer
1679887814OtherNPI
1679887814MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150713001567 MI Part B Supplier - Clinic/Group Practice 9638482128 Receives reassigned benefits from 3 practitioners
Practice locations: Lake Orion, MI

National Provider Directory

National Provider Directory

Locations

81 Indianwood Rd
Lake Orion, MI 48362
Phone (248) 693-2321

Practitioners & affiliated clinicians

Practitioners 5

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": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1881072494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 INDIANWOOD RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 INDIANWOOD RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621595",
            "telephone_number": "248-693-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ORION VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "ZAIR",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "248-693-2321",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679887814",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679887814",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Orion, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.