NPIMap

Organization Active NPI

MVC Acquisition of Sterling Heights PLC

  • Optometrist
  • Sterling Heights, MI
National Provider Identifier
1902247208
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004563 Issued in MI
Legal business name
MVC ACQUISITION OF STERLING HEIGHTS PLC
Practice address
11445 15 Mile Rd
Sterling Heights, MI 48312-3809
Phone
(586) 268-5804
NPI assigned
Jul 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Authorized official

Name
Dr. Andrea K Braden, O.D.
Title
Optometrist
Phone
(734) 693-2874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901004563 MI Primary

Addresses

Primary practice location

11445 15 Mile Rd
Sterling Heights, MI 48312-3809

Mailing address

11445 15 Mile Rd
Sterling Heights, MI 48312-3809

Other names 1

  • Macomb Vision Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1902247208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11445 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483123809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11445 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483123809",
            "telephone_number": "586-268-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MVC ACQUISITION OF STERLING HEIGHTS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "BRADEN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "734-693-2874",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Macomb Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.