Hendrix Optometric Corporation
Organization Active NPI Optometrist · Vincennes, IN
NPI 1013131648 · NPPES record last updated Jun 23, 2016
Key facts
- NPI
- 1013131648
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 56000051A (IN)
- Legal business name
- HENDRIX OPTOMETRIC CORPORATION
- Practice address
- 223 Main St
Vincennes, IN 47591-1208 - Phone
- (812) 882-4809
- Fax
- (812) 882-9485
- NPI assigned
- Apr 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Nathaniel R. Baker, O.D.
- Title
- President
- Phone
- (812) 882-4809
Practitioners 10
-
Nathaniel Rhett Baker, O.D.
-
John Warren Decoursey, O.D.
-
Ryan Geoffrey Kluemper, O.D.
-
Tracy L Crane, OD
-
John Scott Hendrix, O.D.
-
Jason Rodriguez, OD
-
Isaac Steven Schunk, O.D.
-
Eli B Hendrix III, O.D.
-
Dirk J. Bochner, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Eyeworks |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081111000664 | IN | Part B Supplier - Clinic/Group Practice | 6103985767 |
Receives reassigned benefits from 8 practitioners Practice locations: Vincennes, IN; Washington, IN; Linton, IN |
| O20100930063780 | IN | DME Supplier - Physician - Optometrist |
6103985767 | Practice locations: Vincennes, IN |
National Provider Directory
Locations
1057 A St NW
Linton, IN 47441
Phone (812) 847-8615
223 Main St
Vincennes, IN 47591
Phone (812) 882-4809
109 Cherry Tree Plz
Washington, IN 47501
Phone (812) 254-1600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 56000051A | IN | Yes |
Addresses
Primary practice location
223 Main St
Vincennes, IN 47591-1208
Mailing address
223 Main St
Vincennes, IN 47591-1208
Phone (812) 882-4809
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 258660 | Other | IN | MEDICARE GROUP |
| 100319410A | Medicaid | IN |
Other names
- EYEWORKS
NPI Registry JSON
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1466640000000",
"number": "1013131648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 MAIN ST",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475911208",
"telephone_number": "812-882-4809",
"fax_number": "812-882-9485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 MAIN ST",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475911208",
"telephone_number": "812-882-4809",
"fax_number": "812-882-9485"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HENDRIX OPTOMETRIC CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-13",
"last_updated": "2016-06-23",
"status": "A",
"authorized_official_last_name": "BAKER",
"authorized_official_first_name": "NATHANIEL",
"authorized_official_middle_name": "R.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "812-882-4809",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "IN",
"license": "56000051A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "258660",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100319410A",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "EYEWORKS",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Vincennes, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2016. 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.