GR Davich Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

GR DAVICH INC

Practice address

2825 28TH St SE
Suite B
Grand Rapids, MI 49512-1607

Phone

(616) 956-6096

Fax

(606) 956-6074

NPI assigned

Oct 25, 2016

Organization subpart

No

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

Authorized official

Name

Haeri Jang

Title

Manager

Phone

(616) 956-6096

Specialties & licenses 2

Addresses

Other names 1

• Davich Vision Center Former legal business name

Locations

Practitioners 3

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

• Steven A Bathje, OD

  • Optometrist
  • Iron River, MI
  • NPI 1407963168
  NPD (past)
• Manho Jang, O.D.

  • Optometrist
  • Grand Rapids, MI
  • NPI 1205281979
  NPD (past)
• Erica L Touhill-Watson, O.D.

  • Optometrist
  • Rockford, MI
  • NPI 1114237435
  NPD (past)

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1891247813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 28TH ST SE",
            "address_2": "SUITE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121607",
            "telephone_number": "616-956-6096",
            "fax_number": "606-956-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 28TH ST SE",
            "address_2": "SUITE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121607",
            "telephone_number": "616-956-6096",
            "fax_number": "606-956-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GR DAVICH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "JANG",
        "authorized_official_first_name": "HAERI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "616-956-6096"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davich Vision Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jamie Baum Governal, AU.D.
• Charles Gow
• Hayley Anne Goward, MSN, NNP-BC
• Ryan John Gowing, PT, DPT
• GR Acutherapy
• GR Family Therapy PLLC
• GR Sound Sleep LLC (GR Sound Sleep)
• GR Therapy Collective
• Madison Graber, LLMSW
• Natalie Gwen Graber

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.