Midwest Eye Consultants, P.C.
Organization Active NPI Optometrist · Kokomo, IN
NPI 1003879628 · NPPES record last updated Jun 20, 2018
Key facts
- NPI
- 1003879628
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 56000164A (IN)
- Legal business name
- MIDWEST EYE CONSULTANTS, P.C.
- Practice address
- 2705 S Berkley Rd
Kokomo, IN 46902 - Phone
- (765) 453-2200
- Fax
- (765) 453-1768
- NPI assigned
- Apr 7, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- MIDWEST EYE CONSULTANTS, P.C.
Authorized official
- Name
- Gregory L Garner
- Title
- Vice President of Operations
- Phone
- (260) 569-9550
Practitioners 10
-
Charles Mikel Craig, O.D.
-
Lindsay J Culver, O.D.
-
David R Imes, OD
-
Christopher A. James, O.D.
-
Eugene J. McGarvey III, O. D.
-
Kylie Sebastian, OD
-
Jennifer Unger, OD
-
Kevin R Worth, O.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2147583 | Midwest Eye Consultants #25 | Certificate of waiver | Apr 22, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040302000158 | IN | Part B Supplier - Clinic/Group Practice | 2961399217 |
Receives reassigned benefits from 100 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- Garner Trump Eye Care
Locations
2500 E Market St
#3
Logansport, IN 46947
Phone (574) 753-3583
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 56000164A | IN | Yes |
Addresses
Primary practice location
2705 S Berkley Rd
Kokomo, IN 46902
Mailing address
PO Box 549
Wabash, IN 46992-0549
Phone (260) 569-9550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200342590A | Medicaid | IN |
Other names
- Midwest Eye Consultants #25
Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.