Jaimie Lynn Church, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004309 Issued in MI

Practice address

1860 Pipestone Rd
Benton Harbor, MI 49022-2304

Phone

(616) 927-5868

Fax

(616) 934-9485

NPI assigned

Jan 2, 2007

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 names 1

• Jaimie Lynn Behrens Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952468720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2583 LAKE PINE DR",
            "address_2": "#13",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858200",
            "telephone_number": "616-240-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 PIPESTONE RD",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222304",
            "telephone_number": "616-927-5868",
            "fax_number": "616-934-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "JAIMIE",
        "middle_name": "LYNN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIMIE",
            "last_name": "BEHRENS",
            "middle_name": "LYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kisha M. Checkley
• Amarpreet Chela, MD
• Suzanne Rinehart Chrisco-Wilcox, CNM
• Wayne A Christenson Jr., M.D.
• Christian Global Medical Healthcare, Incorporated
• Sarah Cimoch
• Amanda L Clark
• Breonna Clark
• Nicole Elizabeth Clark I
• William Clark

• Optometrist in Benton Harbor, MI
• Providers in Benton Harbor, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.