SOUTH MICHIGAN OPHTHALMOLOGY P C (NPI# 1629224514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629224514 |
| Entity Type | Organization |
| Organization Name | SOUTH MICHIGAN OPHTHALMOLOGY P C |
| Practice Address |
830 W Michigan Ave Marshall MI 49068-1446 |
| Practice Telephone | 2697819822 |
| Practice Fax Number | 2697819835 |
| Mailing Telephone | 2697819822 |
| Mailing Fax Number | 2697819835 |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2010-08-10 |
| Authorized Official Name | DR. DARREN PAUL HATHAWAY (PRESIDENT) |
| Authorized Official Telephone | 2697819822 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 4301073800 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4421664 | 05 |
| Street Address |
830 W MICHIGAN AVE |
| City | MARSHALL |
| State | MI |
| Zip Code | 49068-1446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538276498 | Patricia M Woznicki | Optometrist | 830 W Michigan Ave, Marshall, MI 49068-1446 | 2006-08-24 |
| 1639633431 | Lo Optical, LLC | Eyewear Supplier (Equipment, not the service) | 830 W Michigan Ave, Marshall, MI 49068-1446 | 2019-01-25 |
| 1225573579 | Naiya Panchal | Optometrist | 830 W Michigan Ave, Marshall, MI 49068 | 2016-12-22 |
| 1013156124 | Bradley James Runyon | Optometrist | 830 W Michigan Ave, Marshall, MI 49068-1446 | 2009-02-12 |
| 1518028018 | Darren Paul Hathaway | Ophthalmology | 830 W Michigan Ave, Marshall, MI 49068-1446 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003413774 | Mikeayla Pellegrino | Speech-Language Pathologist | 103 E Mansion St Ricketson Building, Marshall, MI 49068 | 2020-10-06 |
| 1306499108 | Kari Ann Scarbrough | Nurse Practitioner | 200 N Madison, Marshall, MI 49068 | 2019-07-20 |
| 1164994976 | Emily Thrower | Advanced Practice Midwife | 215 E. Mansion Street, Suite 3d, Marshall, MI 49068 | 2018-12-19 |
| 1205359106 | Alexandrea Jade Garbus | Advanced Practice Midwife | 215 E Mansion St Ste 3d, Marshall, MI 49068 | 2017-07-23 |
| 1861948671 | Jaina Schank | Occupational Therapist | 879 E Michigan Avenue, Medilodge of Marshall, Marshall, MI 49068 | 2016-08-31 |
| 1609234426 | Maria Miller | Dental Hygienist | 111 N. Jefferson St, Suite 1, Marshall, MI 49068 | 2016-02-08 |
| 1235594342 | Shelly Wisz | Nurse Practitioner | 720 Old Us 27 North, Marshall, MI 49068 | 2015-12-17 |
| 1225447659 | Charles Middleton | Physical Therapist | 823 W Michigan Ave, Marshall, MI 49068 | 2014-08-11 |
| 1952662538 | Angela Louise Robin | Podiatrist | 1600 S Kalamazoo Ave, Marshall, MI 49068 | 2012-05-31 |
| 1245598606 | Ziad Kanaan | Internal Medicine | 215 E Mansion St Ste 3a, Marshall, MI 49068 | 2012-04-24 |
| Find all providers in zip 49068 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598952749 | King Chiropractic Clinic, Ltd. | Clinic/Center | 511 Locust St, Marshall, IL 62441-1459 | 2007-10-02 |
| 1134752140 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 4 N Jefferson Ave, Marshall, MO 65340-2148 | 2020-02-18 |
| 1780077065 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 2305 South 65 Highway, Marshall, MO 65340-3702 | 2015-03-11 |
| 1710320643 | A Pattern Health Clinic, Inc | Clinic/Center | 1674 S Odell Ave, Marshall, MO 65340-3365 | 2013-04-10 |
| 1215169917 | Progressive Chiropractic & | Clinic/Center | 1203 E Pinecrest Dr, Marshall, TX 75670-7355 | 2009-08-13 |
| 1558388173 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 2305 S 65 Highway, Marshall, MO 65340-3702 | 2006-07-17 |
| 1710904347 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 2305 South 65 Highway, Building A, Marshall, MO 65340-3702 | 2006-07-17 |
| 1437175320 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 2305 South 65 Highway, Building A, Marshall, MO 65340-3702 | 2006-07-14 |
| 1285650176 | John Fitzgibbon Memorial Hospital Inc. | Clinic/Center | 2305 S 65 Highway, Marshall, MO 65340-3702 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730664 | Edward W. Sparrow Hospital Association | Clinic/Center | 2900 Hannah Blvd Ste 204, East Lansing, MI 48823-5382 | 2020-11-03 |
| 1952909558 | Quilted Rose Clinical Services, Pllc | Clinic/Center | 269 Walker St Ste 256, Detroit, MI 48207-4258 | 2020-10-15 |
| 1386250694 | A Better Me Therapy, LLC | Clinic/Center | 2503 S Linden Rd Ste 259, Flint, MI 48532-5462 | 2020-09-22 |
| 1275148165 | Anasthesia Pain Service PC | Clinic/Center | 15350 Michigan Ave, Dearborn, MI 48126 | 2020-09-09 |
| 1659985042 | Passion and Purpose Pediatrics | Clinic/Center | 2944 Olden Oak Ln Apt 204, Auburn Hills, MI 48326-2177 | 2020-09-02 |
| 1710597745 | Renew Child and Family Center | Clinic/Center | 383 Starkweather St, Plymouth, MI 48170-1382 | 2020-08-04 |
| 1467075358 | Shear Pointe Inc | Clinic/Center | 1971 E 14 Mile Rd, Birmingham, MI 48009-7244 | 2020-05-26 |
| 1992326466 | New Healthcare PC | Clinic/Center | 911 Dix St Ste B, Otsego, MI 49078-1609 | 2020-05-06 |
| 1851920581 | Emotional Wellness Group LLC | Clinic/Center | 11956 E Outer Dr, Detroit, MI 48224-2630 | 2020-04-04 |
| 1003445800 | Dr. Chris Popp, PC | Clinic/Center | 107 Aprill Dr Ste 5, Ann Arbor, MI 48103-1956 | 2020-04-03 |
| 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.