John Randall Vance, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002609 Issued in MI

Practice address

1310 Cramer Circle
Pennock 506
Big Rapids, MI 49307-2738

Phone

(231) 591-2222

Fax

(231) 591-3991

NPI assigned

Jul 21, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Ferris State University

  • Ophthalmology Physician
  • Big Rapids, MI
  • NPI 1477574101
  NPD (past)
• Ferris State University

  • Optometrist
  • Big Rapids, MI
  • NPI 1871510859
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982625604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 CRAMER CIRCLE",
            "address_2": "PENNOCK 506",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072738",
            "telephone_number": "231-591-2222",
            "fax_number": "231-591-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 CRAMER CIRCLE",
            "address_2": "PENNOCK 506",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072738",
            "telephone_number": "231-591-2222",
            "fax_number": "231-591-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "JOHN",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR",
            "identifier": "0784610001013",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5095203",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "JV002609",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Tucker, PHARMD
• Twin Family Medical PC
• Nicole Urbon, AGNP-C
• Kevin Daniel Vaillancourt, LLPC
• Keith Valkner, LMSW
• Peter S Vandemark, M.D.
• Scott D Vander Hill, M.D.
• Valerie Joy Vandertol
• Brianna Vanhouten
• Abby Kate Vanotteren-Smith, PA-C

• Optometrist in Big Rapids, MI
• Providers in Big Rapids, 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.