NPIMap

Organization Active NPI

Goodwill Optical Inc

Doing business as Goodwill Optical

  • Optometrist
  • Grand Rapids, MI
National Provider Identifier
1982746053
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GOODWILL OPTICAL INC
Doing business as
Goodwill Optical
Practice address
3270 29TH Steet, SE
Grand Rapids, MI 49512-1875
Phone
(616) 773-6003
Fax
(616) 773-6006
NPI assigned
Feb 13, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Timothy D Westra
Title
President
Phone
(616) 846-0620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X MI Primary

Addresses

Primary practice location

3270 29TH Steet, SE
Grand Rapids, MI 49512-1875

Mailing address

105 W Exchange St
Spring Lake, MI 49456-2024
Phone (616) 846-0620

Other names 1

  • Goodwill Optical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Goodwill Optical15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

3270 29th St SE
Grand Rapids, MI 49512
Phone (616) 773-6003

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1982746053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W EXCHANGE ST",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494562024",
            "telephone_number": "616-846-0620",
            "fax_number": "616-844-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 29TH STEET, SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121875",
            "telephone_number": "616-773-6003",
            "fax_number": "616-773-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WESTRA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-846-0620"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodwill Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 20, 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.