NPIMap

Organization Active NPI

Michigan Medical PC

  • Optometrist
  • Grand Rapids, MI
National Provider Identifier
1952565749
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MICHIGAN MEDICAL PC
Practice address
4069 Lake Dr SE
Suite 315
Grand Rapids, MI 49546-8816
Phone
(616) 464-2890
Fax
(616) 464-2891
NPI assigned
Jul 11, 2008
Last updated
Jul 11, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MICHIGAN MEDICAL PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Scott Harring
Title
Cfo
Phone
(616) 974-4889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

4069 Lake Dr SE
Suite 315
Grand Rapids, MI 49546-8816

Mailing address

4085 Burton St SE
Suite 200
Grand Rapids, MI 49546-2444

National Provider Directory

National Provider Directory
Tax ID family
Michigan Med Spec PC70 organizations share this tax ID, including this one
Part of
Michigan Med Spec PC

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1952565749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 BURTON ST SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4069 LAKE DR SE",
            "address_2": "SUITE 315",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468816",
            "telephone_number": "616-464-2890",
            "fax_number": "616-464-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN MEDICAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHIGAN MEDICAL PC",
        "enumeration_date": "2008-07-11",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "HARRING",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-974-4889"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.