LYNNETTE GAY BURGESS (NPI# 1598750416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598750416 |
| Entity Type | Individual |
| Full Name | LYNNETTE GAY BURGESS |
| Credential | O.D. |
| Practice Address |
4467 Byron Center Ave Sw Wyoming MI 49519-4808 |
| Practice Telephone | 6165344953 |
| Mailing Telephone | 6165344953 |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2013-07-15 |
| NPI Deactivation Date | 03/23/2006 |
| NPI Reactivation Date | 2006-04-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 4901003563 | MI | Eye and Vision Services Providers |
| N | 152WP0200X |
Optometrist Specialization: Pediatrics |
4901003563 | MI | Eye and Vision Services Providers |
| Y | 152WV0400X |
Optometrist Specialization: Vision Therapy |
4901003563 | MI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSE NUMBER | 4901003563 | 01 |
| Street Address |
4467 BYRON CENTER AVE SW |
| City | WYOMING |
| State | MI |
| Zip Code | 49519-4808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427500578 | Lydia Sutton | Nurse Practitioner | 4467 Byron Center Ave Sw, Wyoming, MI 49519-4808 | 2016-10-25 |
| 1699180836 | Scott Anthony Baar | Nurse Practitioner | 4467 Byron Center Ave Sw, Wyoming, MI 49519 | 2014-06-26 |
| 1609294537 | West Michigan Primary Care | Internal Medicine | 4467 Byron Center Ave Sw, Wyoming, MI 49519-4808 | 2014-03-28 |
| 1639418932 | West Michigan Vision Specialists | Optometrist | 4467 Byron Center Ave Sw, Wyoming, MI 49519-4808 | 2013-02-06 |
| 1770753899 | Madrid Psychological Associates | Psychologist | 4467 Byron Center Ave Sw, Wyoming, MI 49519-4808 | 2008-03-04 |
| 1124205547 | South Kent Vision Center PC | Optometrist | 4467 Byron Center Ave Sw, Wyoming, MI 49519-4808 | 2008-01-28 |
| 1699974154 | Kelly Marie Daugherty Zielaskowski | Optometrist | 4467 Byron Center Ave Sw, Wyoming, MI 49519-4808 | 2007-07-15 |
| 1144281718 | Robert Arthur Hohendorf | Optometrist | 4467 Byron Center Ave Sw, Wyoming, MI 49519-4808 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609364009 | Alexandra K Hylen | Dentist | 4489 Byron Center Ave Sw Ste A, Wyoming, MI 49519 | 2018-05-01 |
| 1962925685 | Nicole Lee Kolasa | Rehabilitation Counselor | 2038 Melvin St. Sw, Wyoming, MI 49519 | 2017-07-25 |
| 1720534472 | Michael Ash | Rehabilitation Practitioner | 1870 36th Street, Wyoming, MI 49519 | 2016-08-31 |
| 1891248993 | Kayleigh Saucier | Family Medicine | 5900 Byron Center Avenue Se, Wyoming, MI 49519 | 2016-07-26 |
| 1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
| 1033547658 | Maranda Catherine Gary | Nurse Practitioner | 2122 Health Drive, Wyoming, MI 49519 | 2013-10-16 |
| 1144657800 | Diana Ro | Psychologist | 4211 Parkway Place Sw, #100, Wyoming, MI 49519 | 2013-09-26 |
| 1386077873 | Lindsey Elizabeth Chorney | Nurse Practitioner | 2122 Health Drive Sw, Suite 133, Wyoming, MI 49519 | 2013-08-20 |
| 1124377163 | Vision and Sensory Center of Michigan LLC | Optometrist | 4467 Byron Center Ave., Wyoming, MI 49519 | 2012-09-06 |
| 1881940203 | Judah | Durable Medical Equipment & Medical Supplies | 2975 Waterchase Way Sw Suite 307, Wyoming, MI 49519 | 2012-08-03 |
| Find all providers in zip 49519 | ||||
| Taxonomy Code | 152WV0400X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Vision Therapy |
| Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639418932 | West Michigan Vision Specialists | Optometrist | 4467 Byron Center Ave Sw, Wyoming, MI 49519-4808 | 2013-02-06 |
| 1144281718 | Robert Arthur Hohendorf | Optometrist | 4467 Byron Center Ave Sw, Wyoming, MI 49519-4808 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427585801 | Frye's New Look Optical | Optometrist | 12897 Woodward Ave, Highland Park, MI 48203-3315 | 2017-05-17 |
| 1548628415 | Academy of Vision Development, Pllc | Optometrist | 6617 Crossings Dr Se, Suite 102, Grand Rapids, MI 49508-7378 | 2016-02-05 |
| 1548675242 | Davich Midwest Inc | Optometrist | 2825 28th St Se, Grand Rapids, MI 49512-1607 | 2014-06-22 |
| 1063844108 | Tuan Tran | Optometrist | 19700 14 Mile Rd, C306, Big Rapids, MI 49307-8757 | 2013-07-31 |
| 1932300928 | Vision Associates of Westland | Optometrist | 38979 Cherry Hill Rd., Suite B, Westland, MI 48186 | 2007-05-29 |
| 1437212560 | John Paul Jacobi | Optometrist | 32415 5 Mile Rd, Livonia, MI 48154-3039 | 2006-12-19 |
| 1174590285 | Randy Gerard Houdek | Optometrist | 38979 Cherry Hill Rd, Suite B, Westland, MI 48186-3250 | 2006-03-07 |
| 1285293738 | G Stephanie Enriquez Od Pllc | Optometrist | 4091 Richfield Rd, Flint, MI 48506-2033 | 2019-06-09 |
| 1801383260 | Vision Therapy Institute of Mi, LLC | Optometrist | 330 W Lake Lansing Rd, East Lansing, MI 48823-8527 | 2018-04-20 |
| 1891247813 | Gr Davich Inc | Optometrist | 2825 28th St Se, Suite B, Grand Rapids, MI 49512-1607 | 2016-10-25 |
| Find all providers with the same taxonomy | ||||
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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.