ROBERT D & CINDY L DOUGLAS (NPI# 1023287836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023287836 |
| Entity Type | Organization |
| Organization Name | ROBERT D & CINDY L DOUGLAS |
| Practice Address |
12412 Stafford Ravenna MI 49451-0307 |
| Mailing Address |
12412 Stafford Rd Ravenna MI 49451-9783 |
| Practice Telephone | 2318536459 |
| Practice Fax Number | 2318536459 |
| Mailing Telephone | 2318536459 |
| Mailing Fax Number | 2318536459 |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2008-09-23 |
| Authorized Official Name | CINDY LEE DOUGLAS (OPTICIAN) |
| Authorized Official Telephone | 2318536459 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156F00000X | Technician/Technologist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | DAVIS VISION | 56038 | 01 |
| MI | BLUE CROSS BLUESHIELD | 900F176110 | 01 |
| MI | EYE MED | OP0965 | 01 |
| Street Address |
12412 STAFFORD |
| City | RAVENNA |
| State | MI |
| Zip Code | 49451-0307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356740245 | Crockery Creek Elder Care, Inc | Assisted Living Facility | 12291 Crockery Creek Dr., Ravenna, MI 49451 | 2014-08-18 |
| 1114251139 | Alisha Lewise Warner | Nurse's Aide | 155 S. Trent Rd., Ravenna, MI 49451 | 2009-09-23 |
| 1346413309 | Kelley Marie Young | Nurse Practitioner | 12520 Crockery Creek Drive, Ravenna, MI 49451 | 2008-04-10 |
| 1508084310 | Bonnie Jean Pline | Family Medicine | 1042 S. Ravenna Rd., Ravenna, MI 49451 | 2007-04-24 |
| 1083619936 | Timothy L Beechnau | Family Medicine | 12520 Crockery Creek Dr., Ravenna, MI 49451 | 2005-06-16 |
| 1417279407 | Apple Family Medicine, P.l.c. | Clinic/Center | 1042 S Ravenna Rd, Ravenna, MI 49451 | 2010-02-18 |
| 1497928469 | Ravenna Family Practice, P.C. | Family Medicine | 12520 Crockery Creek Dr., Ravenna, MI 49451 | 2008-04-10 |
| 1063455129 | Craig R Cameron Dds Plc | Dentist | 12374 Stafford Street, Ravenna, MI 49451-0204 | 2006-06-14 |
| 1083809917 | Craig Robert Cameron | Dentist | 12374 Stafford Street, Ravenna, MI 49451-0204 | 2007-09-13 |
| 1164784724 | Nicholas S Beechnau | Family Medicine | 12520 Crockery Creek Dr, Ravenna, MI 49451-5100 | 2012-06-11 |
| Find all providers in zip 49451 | ||||
| Taxonomy Code | 156F00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| A broad category grouping different kinds of technologists and technicians. See individual definitions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173942 | Madison Lynn-grayce Baker | Technician/Technologist | 32100 Telegraph Rd # 32100205, Bingham Farms, MI 48025-2452 | 2020-10-27 |
| 1164021424 | Jennifer Julia Schneider Stahl | Technician/Technologist | 1327 Cynthia Ave, Madison Heights, MI 48071-2697 | 2020-10-19 |
| 1114525847 | Monica Nikollbibaj | Technician/Technologist | 49970 Van Dyke Ave, Shelby Township, MI 48317-1347 | 2020-10-14 |
| 1992312342 | Brittany Moeller | Technician/Technologist | 1200 E Grand River Ave Apt 27, East Lansing, MI 48823-4922 | 2020-09-29 |
| 1639785801 | Diamond B Haynes | Technician/Technologist | 32100 Telegraph Rd Ste 209, Bingham Farms, MI 48025-2454 | 2020-09-22 |
| 1326654013 | Mariah Pino | Technician/Technologist | 15004 Mclain Ave, Allen Park, MI 48101-1819 | 2020-09-18 |
| 1518571413 | Cole Nicolas Gomez | Technician/Technologist | 32199 Telegraph Rd, Bingham Farms, MI 48025 | 2020-09-08 |
| 1245842079 | Wasseem Haidar | Technician/Technologist | 32100 Telegraph Rd Ste 20548025, Bingham Farms, MI 48025-2452 | 2020-08-21 |
| 1336759158 | Cameron White | Technician/Technologist | 32100, Suite 205, Bingham Farms, MI 48025-2452 | 2020-08-06 |
| 1346859212 | Jordyn Jones | Technician/Technologist | 32199 Telegraph Rd Ste 205, Bingham Farms, MI 48025 | 2020-07-27 |
| 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.