MEDICAL VILLAGE OPTICAL SHOPPE INC. (NPI# 1033567490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033567490 |
| Entity Type | Organization |
| Organization Name | MEDICAL VILLAGE OPTICAL SHOPPE INC. |
| Other Organization Name | OPTICAL DESIGNS |
| Practice Address |
31815 Southfield Rd Suite #12 Beverly Hills MI 48025-5471 |
| Practice Telephone | 2486452220 |
| Practice Fax Number | 8775478277 |
| Mailing Telephone | 2486452220 |
| Mailing Fax Number | 8775478277 |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |
| Authorized Official Name | ROY KNOERR (PRESIDENT) |
| Authorized Official Telephone | 2486452220 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| N | 156FC0800X |
Technician/Technologist Specialization: Contact Lens |
Eye and Vision Services Providers | ||
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Optical Designs | Doing Business As Name - Organization |
| Street Address |
31815 SOUTHFIELD RD SUITE #12 |
| City | BEVERLY HILLS |
| State | MI |
| Zip Code | 48025-5471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568452761 | Herbert J Roth Sr. | Pediatrics | 31815 Southfield Rd, Ste 14, Beverly Hills, MI 48025-5471 | 2005-10-27 |
| 1578027991 | Marcia Jean Klucznik | Counselor | 31815 Southfield Rd, Beverly Hills, MI 48025-5471 | 2019-01-30 |
| 1609366434 | Steven Daniel Light | Chiropractor | 31815 Southfield Rd, Suite 17, Beverly Hills, MI 48025 | 2018-05-17 |
| 1356876288 | Small Talk Centers Pllc | Speech-Language Pathologist | 31815 Southfield Rd, Suite 11, Beverly Hills, MI 48025-5471 | 2017-04-28 |
| 1629516687 | Tina Sappington | Speech-Language Pathologist | 31815 Southfield Rd, Suite 11, Beverly Hills, MI 48025-5471 | 2017-02-09 |
| 1912309352 | Mas Counseling Services, Pllc | Social Worker | 31815 Southfield Rd, Suite 27, Beverly Hills, MI 48025-5471 | 2014-09-17 |
| 1407298516 | Deborah Kay Petersen-brand | Mechanotherapist | 31815 Southfield Rd, Ste. 17, Beverly Hills, MI 48025-5471 | 2013-07-18 |
| 1336581453 | Karleen Rosita Brown | Mechanotherapist | 31815 Southfield Rd, Suite 17, Beverly Hills, MI 48025-5471 | 2013-07-18 |
| 1497197545 | Heather Leighmcpherson Hunt | Reflexologist | 31815 Southfield Rd, Ste 17, Beverly Hills, MI 48025-5471 | 2013-07-17 |
| 1962780767 | Village Pediatrics Pllc | Pediatrics | 31815 Southfield Rd, Suite 14, Beverly Hills, MI 48025-5471 | 2011-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571413 | Cole Nicolas Gomez | Technician/Technologist | 32199 Telegraph Rd, Bingham Farms, MI 48025 | 2020-09-08 |
| 1346859212 | Jordyn Jones | Technician/Technologist | 32199 Telegraph Rd Ste 205, Bingham Farms, MI 48025 | 2020-07-27 |
| 1013492644 | Shaniya Hyman | Technician/Technologist | 32100 Telegraph Rd Suit 205, Bingham Farms, MI 48025 | 2018-09-28 |
| 1043799042 | Assisted Home Health | Hospice Care, Community Based | 20150 Plantation Ln, Beverly Hills, MI 48025 | 2018-08-09 |
| 1235618224 | Robert Dean Harley | Technician/Technologist | 31200 Telegraph Rd Ste 205, Bingham Farms, MI 48025 | 2018-08-09 |
| 1760973911 | Tailormed Medical Inc | Case Management | 30100 Telegraph Road, Suite 403, Bringham Farms, MI 48025 | 2018-05-23 |
| 1245745447 | Supportive Home Health Care LLC | Home Health | 30100 Telegraph Rd Ste 478, Bingham Farms, MI 48025 | 2017-12-11 |
| 1265954192 | Breeona Rue | Technician/Technologist | 32100 Telegraph Rd Suite 205, Bingham Farms, MI 48025 | 2017-07-12 |
| 1417478132 | Gina Maria Bignotti | Behavior Technician | 32100 Telegraph, Bingham Farms, MI 48025 | 2017-07-03 |
| 1295256238 | Chanel Matti | Behavior Technician | 32100 Telegraph Rd Suite 185, Bingham Farms, MI 48025 | 2017-06-29 |
| Find all providers in zip 48025 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700900610 | H. Silani | Technician/Technologist | 210 S Robertson Blvd, Beverly Hills, CA 90211-2811 | 2007-03-17 |
| 1750725198 | Leontyne Eunice Thompson Love | Technician/Technologist | 468 N Camden Dr, Suite 200, Beverly Hills, CA 90210-4507 | 2013-04-27 |
| 1801106976 | Roy Knoerr | Technician/Technologist | 31815 Southfield Rd, Ste 27, Beverly Hills, MI 48025-5471 | 2010-10-07 |
| 1245558782 | Eric Knoerr | Technician/Technologist | 31815 Southfield Rd, Suite 12, Beverly Hills, MI 48025-5471 | 2010-05-07 |
| 1073572962 | Medical Village Optical Shoppe Inc | Technician/Technologist | 31815 Southfield Rd, Suite 12, Beverly Hills, MI 48025-5471 | 2006-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588201420 | William Wise | Technician/Technologist | 410 North St, Otisville, MI 48463-9705 | 2019-12-10 |
| 1033750658 | American Eye Institute Optical Inc | Technician/Technologist | 2300 Haggerty Rd Ste 1100, West Bloomfield, MI 48323-2185 | 2019-10-04 |
| 1225595705 | National Vision Inc | Technician/Technologist | 1328 S Rochester Rd, Rochester Hills, MI 48307-3124 | 2019-02-21 |
| 1184191306 | National Vision Inc | Technician/Technologist | 50697 Waterside Dr, Chesterfield, MI 48051-4008 | 2018-10-25 |
| 1275045916 | W. Optical 4 LLC | Technician/Technologist | 1004 28th St Sw, Wyoming, MI 49509-2881 | 2017-11-03 |
| 1164932489 | Salim Rufo Auraha | Technician/Technologist | 3747 15 Mile Rd, Sterling Heights, MI 48310-5358 | 2017-10-02 |
| 1720527955 | Wal-mart Stores East, Lp | Technician/Technologist | 2755 W Holton-whitehall Rd, Whitehall, MI 49461 | 2017-02-21 |
| 1811434293 | Joseph Frye-dandridge | Technician/Technologist | 18669 Oakfield St, Detroit, MI 48235-3060 | 2017-01-24 |
| 1689110710 | W. Optical 2 LLC | Technician/Technologist | 3233 Alpine Ave Nw Ste A, Grand Rapids, MI 49544-1631 | 2017-01-12 |
| 1811377740 | Kat Stannis LLC | Technician/Technologist | 1794 N Old Us 23, Howell, MI 48843-7193 | 2015-06-05 |
| Find all providers with the same taxonomy | ||||
| City | BEVERLY HILLS |
| Zip Code | 48025 |
Please comment or provide details below to improve the information on MEDICAL VILLAGE OPTICAL SHOPPE INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.