DR. KEVIN BENJAMIN VANDENBOSCH (NPI# 1215299367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215299367 |
| Entity Type | Individual |
| Full Name | DR. KEVIN BENJAMIN VANDENBOSCH |
| Credential | O.D. |
| Practice Address |
1116 W Ganson St Jackson MI 49202-4240 |
| Mailing Address |
4615 Bremer St Sw Grandville MI 49418-2239 |
| Practice Telephone | 8778528463 |
| Practice Fax Number | 5177825166 |
| Mailing Telephone | 6162405632 |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 4901004710 | MI | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265701890 | Kevin Lee Vandenbosch | Massage Therapist | 202 Auburn Ave, Auburn, WA 98002-5015 | 2011-12-28 |
| Street Address |
1116 W GANSON ST |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-4240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629073036 | Kevin Lavery | Ophthalmology | 1116 W Ganson St, Jackson, MI 49202-4240 | 2005-06-14 |
| 1336766153 | Abigail Maynard | Optometrist | 1116 W Ganson St, Jackson, MI 49202-4240 | 2020-06-27 |
| 1881101582 | Joshua R Halm | Optometrist | 1116 W Ganson St, Jackson, MI 49202-4240 | 2018-01-03 |
| 1922360650 | Tiffany Rose Humes | Optometrist | 1116 W Ganson St, Jackson, MI 49202-4240 | 2012-06-08 |
| 1245590868 | Mahmoud H El-yassir | Ophthalmology | 1116 W Ganson St, Jackson, MI 49202-4240 | 2012-05-17 |
| 1811204571 | Lindsey Wynkoop | Optometrist | 1116 W Ganson St, Jackson, MI 49202-4240 | 2010-09-01 |
| 1659421253 | Angela M Cumming | Optometrist | 1116 W Ganson St, Jackson, MI 49202-4240 | 2007-01-12 |
| 1922069939 | Sujata Purohit | Ophthalmology | 1116 W Ganson St, Jackson, MI 49202-4240 | 2006-03-29 |
| 1023006327 | John P Veith | Optometrist | 1116 W Ganson St, Jackson, MI 49202-4240 | 2005-10-11 |
| 1508861659 | Paul H Ernest | Ophthalmology | 1116 W Ganson St, Jackson, MI 49202-4240 | 2005-06-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548884307 | Bricker B Buseth | Optometrist | 2500 Reynolds Rd, Jackson, MI 49201-9376 | 2020-06-07 |
| 1922667682 | Brittany Renee Bryant | Optometrist | 119 Stonebrook Pl Ste A, Jackson, TN 38305-3636 | 2019-06-06 |
| 1023504818 | Trent Wayne Martin | Optometrist | 1000 Vann Dr Ste A, Jackson, TN 38305-6062 | 2018-07-05 |
| 1417478835 | Mason Ross Womack | Optometrist | 810 Court St # 10, Jackson, CA 95642-2132 | 2017-07-06 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1174923189 | Lindsay Katharine Klumpp | Optometrist | 850 W North St, Ste. 100, Jackson, MI 49202-3196 | 2014-08-27 |
| 1700200227 | Mobile Vision LLC | Optometrist | 1737 Spring Arbor Rd # 164, Jackson, MI 49203-2701 | 2014-02-05 |
| 1831430925 | First Sight LLC | Optometrist | 1316 N State St, Jackson, MS 39202-2003 | 2013-03-14 |
| 1447506381 | Morgan Allyce Strand | Optometrist | 2954 E. Jackson Blvd, Jackson, MO 63755 | 2012-07-30 |
| 1083847776 | The Center for Sight P.C. | Optometrist | 3595 Ann Arbor Rd, Jackson, MI 49202-2703 | 2009-08-27 |
| Find all providers in JACKSON | ||||
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| 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.