Carol Allen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004371 Issued in MI

Practice address

3957 24TH Ave
Fort Gratiot, MI 48059-4102

Phone

(810) 984-5005

NPI assigned

Feb 21, 2007

Last updated

Jun 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Myeyedr Optometry of Michigan LLCGroup PAC ID 7416288949, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myeyedr Optometry of Michigan, LLC

  dba MyEyeDr.

  • Optometrist
  • Shelby Township, MI
  • NPI 1639723596
  Medicare reassignment Care Compare group NPD
• Blue Water Eye Care Associates PC

  • Ophthalmology Physician
  • Port Huron, MI
  • NPI 1104081819
  Medicare reassignment NPD
• Myeyedr Optometry of Michigan, LLC

  dba MyEyeDr.

  • Optometrist
  • Clarkston, MI
  • NPI 1215753553
  NPD
• Myeyedr Optometry of Michigan, LLC

  dba MyEyeDr.

  • Optometrist
  • Fort Gratiot, MI
  • NPI 1598359424
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1902941537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3957 24TH AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594102",
            "telephone_number": "810-984-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK VISION",
            "identifier": "929491",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alcott Blue Water Chiropractic, Inc. (Blue Water Chiropractic)
• Scott Douglas Alcott, D.C.
• Joji Alex, NP-C
• Rachelle Ann Alexander
• Victoria Alexander
• Amazing Dental Port Huron PLLC (Amazing Dental Port Huron)
• American Health Psychology Assessment & Consulting
• Trina Anderson
• Anthony J. Bianchi DPM P.C.
• Apheresis and Transfusion Medicine of Port Huron PLLC

• Optometrist in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.