KENNETH JOHN SUPPES (NPI# 1972617355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972617355 |
| Entity Type | Individual |
| Full Name | KENNETH JOHN SUPPES |
| Credential | OD |
| Practice Address |
1885 N Center Rd Saginaw MI 48638-5565 |
| Practice Telephone | 9897926627 |
| Mailing Telephone | 9897926627 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 4901002383 | MI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4742508 | 05 |
| Street Address |
1885 N CENTER RD |
| City | SAGINAW |
| State | MI |
| Zip Code | 48638-5565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134114531 | C. Steven Kocks | Optometrist | 1885 N Center Rd, Saginaw, MI 48638-5565 | 2005-09-13 |
| 1275618050 | Associates In Eyecare, Plc | Durable Medical Equipment & Medical Supplies | 1885 N Center Rd, Saginaw, MI 48638-5565 | 2006-10-27 |
| 1174637565 | Associates In Eyecare, Plc | Durable Medical Equipment & Medical Supplies | 1885 N Center Rd, Saginaw, MI 48638-5565 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235604547 | Kristina Susan Spohn | Behavior Technician | 300 Saint Andrews Rd Ste 408, Saginaw, MI 48638 | 2018-10-12 |
| 1538686803 | Jennifer A Nickels | Behavioral Analyst | 300 Saint Andrews Rd Ste 409, Saginaw, MI 48638 | 2017-08-27 |
| 1013209634 | Ryan D Michelson Dds Plc | Dentist | 65 North Frost Drive, Saginaw, MI 48638 | 2011-05-16 |
| 1477645539 | Mark Walter Pankonin | Family Medicine | 1600 Midland Rd, Saginaw, MI 48638 | 2006-09-28 |
| 1386735579 | John Edwin Galsterer | Dentist | 5605 Colony Drive North, Saginaw, MI 48638 | 2006-09-27 |
| 1699873075 | Phadej Keopunna | Urology | 70 North Frost Dr, Saginaw, MI 48638 | 2006-09-20 |
| 1790881902 | Jeffrey John Dwan | Dentist | 595 N Center Rd, Ste 5, Saginaw, MI 48638 | 2006-09-15 |
| 1396705364 | Christina Marie Barba | Physical Therapist | 4884 Gratiot Avenue, Suite 19, Saginaw, MI 48638 | 2006-03-24 |
| 1538136353 | Joseph E Oesterling | Specialist | 1740 Midland Rd, Saginaw, MI 48638 | 2006-03-01 |
| 1558916650 | Kayela Lynn Oberloier | Behavior Technician | 300 Saint Andrews Rd Ste 408, Saginaw, MI 48638 | 2019-08-06 |
| Find all providers in zip 48638 | ||||
| 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 |
|---|---|---|---|---|
| 1154921815 | Daniel & Max, LLC | Optometrist | 5020 Bay Rd, Saginaw, MI 48604-2522 | 2020-10-30 |
| 1982845384 | Envision Eye Care Pllc | Optometrist | 5310 Hampton Place, Suite 2, Saginaw, MI 48604-8202 | 2009-03-13 |
| 1376737635 | Goodwill Optical Inc | Optometrist | 405 S Michigan Ave, Saginaw, MI 48602-2026 | 2007-08-30 |
| 1760604854 | Matthew Thomas Kisabeth | Optometrist | 5650 Bay Road, Saginaw, MI 48604 | 2007-05-02 |
| 1609905603 | John Michael Yancho | Optometrist | 4900 Fashion Square Mall, Saginaw, MI 48604-2706 | 2007-03-05 |
| 1629118351 | Jerry C. Appold | Optometrist | 4900 Fashion Square Blvd, Sears Optical, Saginaw, MI 48604-2610 | 2007-02-08 |
| 1952462384 | Kenneth G Larson | Optometrist | 4580 State St, Green Acres Plaza, Saginaw, MI 48603-3803 | 2006-12-12 |
| 1568474518 | Paul K Douglas | Optometrist | 1205 N Michigan Ave, Saginaw, MI 48602-4729 | 2006-08-11 |
| 1114935426 | Joseph K Douglas | Optometrist | 5025 Shattuck Rd, Saginaw, MI 48603 | 2006-08-03 |
| 1154336931 | Special Needs Vision Clinic | Optometrist | 3660 Southfield Dr, Saginaw, MI 48601-5653 | 2006-07-30 |
| Find all providers in SAGINAW | ||||
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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.