Active NPI
Kenneth Holmberg, O.D.
- Optometrist
- Lansing, MI
National Provider Identifier
1922244276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004504
- Practice address
- 3225 Towne Centre Blvd
Lansing, MI 48912-5620 - Phone
- (517) 487-9166
- NPI assigned
- Dec 16, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004504 | MI | Primary |
Addresses
Primary practice location
3225 Towne Centre Blvd
Lansing, MI 48912-5620
Mailing address
3225 Towne Centre Blvd
Lansing, MI 48912-5620
Phone (517) 487-9166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546041600000",
"number": "1922244276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3225 TOWNE CENTRE BLVD",
"city": "LANSING",
"state": "MI",
"postal_code": "489125620",
"telephone_number": "517-487-9166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3225 TOWNE CENTRE BLVD",
"city": "LANSING",
"state": "MI",
"postal_code": "489125620",
"telephone_number": "517-487-9166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMBERG",
"first_name": "KENNETH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-16",
"last_updated": "2018-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.