DR. MAXWELL EDWARD RENNAKER (NPI# 1366934879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366934879 |
| Entity Type | Individual |
| Full Name | DR. MAXWELL EDWARD RENNAKER |
| Credential | OD |
| Practice Address |
2700 5 Mile Rd Ne Ste 102 Grand Rapids MI 49525-6516 |
| Mailing Address |
3736 Prairie St Sw Grandville MI 49418-1634 |
| Practice Telephone | 3309088000 |
| Mailing Telephone | 6166488456 |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2020-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 4901005238 | MI | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | OPT.006660 | OH | Eye and Vision Services Providers |
| Street Address |
2700 5 MILE RD NE STE 102 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-6516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| 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 |
|---|---|---|---|---|
| 1295352987 | Ashleigh Yates | Optometrist | 3152 Peregrine Dr Ne Ste 205, Grand Rapids, MI 49525-9723 | 2020-06-29 |
| 1659997252 | Peter Silman | Optometrist | 3152 Peregrine Dr Ne # C205, Grand Rapids, MI 49525-9723 | 2020-06-19 |
| 1821613225 | Adam Hoffhines | Optometrist | 3159 28th St Se, Grand Rapids, MI 49512-7810 | 2020-06-11 |
| 1184283285 | Carrie Mitera | Optometrist | 1712 Timberlane Ln Ne, Grand Rapids, MI 49505-4442 | 2019-06-12 |
| 1750830261 | Rx Optical Laboratories, Inc | Optometrist | 2000 E Beltline Ave Ne, Grand Rapids, MI 49525-9716 | 2016-09-26 |
| 1851759716 | Premier Family Eye Care PC. | Optometrist | 6748 Kalamzoo Ave S.e, Grand Rapids, MI 49508-7032 | 2016-02-08 |
| 1093198483 | I Care Optics LLC | Optometrist | 2425 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4652 | 2015-07-02 |
| 1891103818 | Adeline Bauer | Optometrist | 1000 E Paris Ave Se Ste 130, Grand Rapids, MI 49546-3680 | 2014-07-23 |
| 1790106136 | Rx Optical Laboratories, Inc. | Optometrist | 1844 Breton Rd Se, Grand Rapids, MI 49506-4869 | 2014-01-03 |
| 1922344894 | Rx Optical Laboratories, Inc. | Optometrist | 1858 Breton Rd Se, Grand Rapids, MI 49506-4869 | 2012-12-21 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
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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.