THREE RIVERS EYE CARE
Complete NPI Record 1124653209
Eyewear Supplier in Grand Rapids, MI
Active since March 09, 2020
Complete NPI Dataset
This page contains the complete raw NPPES record for Three Rivers Eye Care (NPI 1124653209), an eyewear supplier organization in Grand Rapids, MI. All 27 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1124653209 Field 1/27
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/27
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/27
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: GRO OPTICAL, LLC Field 4/27
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: THREE RIVERS EYE CARE Field 5/27
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 3 Field 6/27
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: 4020 E BELTLINE AVE NE STE 201 Field 7/27
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: GRAND RAPIDS Field 8/27
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: MI Field 9/27
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 495259324 Field 10/27
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/27
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider First Line Business Practice Location Address: 750 E BELTLINE AVE NE Field 12/27
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: GRAND RAPIDS Field 13/27
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: MI Field 14/27
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 495256049 Field 15/27
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 16/27
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 6169421350 Field 17/27
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: THERRIEN Field 20/27
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: KELLY Field 21/27
- The first name of the authorized official.
- Authorized Official Title or Position: OPTICAL BILLING SYSTEMS MANAGER Field 22/27
- The title or position of the authorized official.
- Authorized Official Telephone Number: 6165886532 Field 23/27
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 332H00000X Field 24/27
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 25/27
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: N Field 26/27
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Other Organization Names 11
Additional business and trade names this provider has on file with the NPPES registry.
Blue Sky Vision Three Rivers Doing Business As
Name 1/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Eyecare Associated of Haslett Doing Business As
Name 2/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
GRO Optical Doing Business As
Name 3/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
GRO Optical LLC Doing Business As
Name 4/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Lakeshore Eye Doing Business As
Name 5/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Michael L. Sussex, OD Doing Business As
Name 6/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Michigan Optical Doing Business As
Name 7/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Optometrists of Lansing Doing Business As
Name 8/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Sussex Vision Center Doing Business As
Name 9/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Visioncare Associates Doing Business As
Name 10/11Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Grand Rapids Opticians LLC Former Legal Business Name
Name 11/11Former Legal Business Name: A previous registered legal name once used by an organization that has since been changed or retired.
Secondary Practice Locations 14
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
537 W Main St
Location 1/14Ionia, MI 48846-1652 · Phone (616) 523-2020
3300 Walker Vw NW
Location 2/14Walker, MI 49544-9139 · Phone (616) 776-7979
56847 N Main St
Location 3/14Three Rivers, MI 49093-9615 · Phone (269) 273-2020
6050 Northland Dr NE Ste 100
Location 4/14Rockford, MI 49341-9257 · Phone (616) 588-6582
2117 E Grand River Ave
Location 5/14Lansing, MI 48912-3231 · Phone (517) 485-2213
3235 N Wellness Dr Ste 130
Location 6/14Holland, MI 49424-7265 · Phone (616) 994-9586
112 S Clay St
Location 7/14Greenville, MI 48838-1914 · Phone (616) 754-5667
4475 Wilson Ave SW
Location 8/14Grandville, MI 49418-2368 · Phone (616) 249-0100
511 Wilson Ave NW Ste E
Location 9/14Grand Rapids, MI 49534-7986 · Phone (616) 301-8663
717 Bagley Ave SE
Location 10/14Grand Rapids, MI 49506-3001 · Phone (616) 588-6575
80 68th St SE
Location 11/14Grand Rapids, MI 49548-6980 · Phone (616) 827-0003
310 W Lake Lansing Rd
Location 12/14East Lansing, MI 48823-1438 · Phone (517) 337-8182
350 Marshall St
Location 13/14Coldwater, MI 49036-1175 · Phone (517) 278-6303
10047 Crossroad Ct SE
Location 14/14Caledonia, MI 49316-7316 · Phone (616) 588-6556
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