EDWARD P STACK (NPI# 1801899885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801899885 |
| Entity Type | Individual |
| Full Name | EDWARD P STACK |
| Credential | M.D. |
| Practice Address |
4281 Lennon Rd Flint MI 48507-1024 |
| Practice Telephone | 8107209111 |
| Practice Fax Number | 8107209119 |
| Mailing Telephone | 8107209111 |
| Mailing Fax Number | 8107209119 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 4301065179 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | AETNA | 5100110 | 01 |
| MI | CAPE MEDICAID | 000000010198 | 01 |
| MI | CIGNA | 6736673005 | 01 |
| MI | MIDWEST HEALTH | 028341 | 01 |
| MA | SPECTERA | 15474 | 01 |
| MI | STATE LICENSE NUMBER | 4301065179 | 01 |
| MI | 4604520 | 05 | |
| MI | MCARE | C6993 | 01 |
| MI | CARE CHOICES | 110201 | 01 |
| MI | BCBSM | 1802511821 | 01 |
| MI | 4774225 | 05 |
| Street Address |
4281 LENNON RD |
| City | FLINT |
| State | MI |
| Zip Code | 48507-1024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073706578 | Kelly C-k Tierney | Optometrist | 4281 Lennon Rd, Flint, MI 48507-1024 | 2007-08-20 |
| 1780746081 | Michigan Vision Institute Pllc | Ophthalmology | 4281 Lennon Rd, Flint, MI 48507-1024 | 2006-12-14 |
| 1346343878 | Robert Jay Zendler II Do PC | Ophthalmology | 4281 Lennon Rd, Flint, MI 48507 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847870 | Alexis Nichole Leach | Physician Assistant | 5494 South Dort Hwy, Flint, MI 48507 | 2020-09-28 |
| 1508330317 | Jeffrey Mark Funck | Registered Nurse | G-4443 Miller Road, Suite 100, Flint, MI 48507 | 2019-01-15 |
| 1861981292 | Lavonne L Alexander | Nurse Practitioner | 4500 S Saginaw St Ste 1875, Flint, MI 48507 | 2018-05-01 |
| 1760984348 | Melissa Dawn Hoffman | Psychologist | 5402 Gateway Centre Drive, Suite B, Flint, MI 48507 | 2018-02-28 |
| 1902327323 | Katee Mast | Case Manager/Care Coordinator | 110 Eldon Baker Drive, Flint, MI 48507 | 2017-07-06 |
| 1699228460 | Joshua Sinclair | Social Worker | 2442 E Maple Ave Ste 207, Flint, MI 48507 | 2016-07-28 |
| 1477903730 | Gracie Hunter | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1110 Eldon Baker, Flint, MI 48507 | 2016-06-17 |
| 1528412822 | Drita Gojcaj | Massage Therapist | 3426 Miller Road, Flint, MI 48507 | 2016-04-22 |
| 1629422100 | Ellen Makarewicz-ely | Massage Therapist | 3426 Miller Rd, Flint, MI 48507 | 2016-04-20 |
| 1700262722 | Katelyn Bailey | Nurse Practitioner | 1420 W Twelfth St, Flint, MI 48507 | 2015-07-31 |
| Find all providers in zip 48507 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376957043 | Trevor Alan Smith | Ophthalmology | 5300 Gateway Ctr, Flint, MI 48507-3930 | 2014-06-20 |
| 1437110608 | Complete Eye Care, P.C. | Ophthalmology | 5055 W Bristol Rd, Flint, MI 48507-2922 | 2006-03-29 |
| 1043289150 | Steven Allen Boskovich | Ophthalmology | 1290 S Linden Rd, Flint, MI 48532-3407 | 2006-03-14 |
| 1629040068 | Daniel Joseph Ryan | Ophthalmology | 1113 Villa Linde Ct, Flint, MI 48532 | 2006-02-01 |
| 1740559756 | Lansing Ophthalmology | Ophthalmology | 4499 Town Center Pkwy, Flint, MI 48532-3425 | 2011-12-20 |
| 1972880268 | Leroy Johnson | Ophthalmology | 2900 N Saginaw St, Flint, MI 48505-4452 | 2011-11-15 |
| 1669686515 | Robert Jay Zendler II | Ophthalmology | 1335 S Linden Rd, Suite E, Flint, MI 48532 | 2007-05-10 |
| 1710043641 | Daniel J Ryan Md PC | Ophthalmology | 1113 Villa Linde Ct, Flint, MI 48532-3410 | 2006-12-28 |
| 1780746081 | Michigan Vision Institute Pllc | Ophthalmology | 4281 Lennon Rd, Flint, MI 48507-1024 | 2006-12-14 |
| 1316008774 | Mei Operations, Pllc | Ophthalmology | 4499 Town Center Pkwy, Flint, MI 48532-3425 | 2006-12-12 |
| Find all providers in FLINT | ||||
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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.