NPIMap

Christopher J. Wolf, OD, Inc

Organization Active NPI Optometrist · South Bend, IN

NPI 1023069283 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1023069283
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
18001614 (IN)
Legal business name
CHRISTOPHER J. WOLF, OD, INC
Practice address
4123 S Michigan St
South Bend, IN 46614-2545
Phone
(574) 291-8900
Fax
(574) 299-8503
NPI assigned
May 13, 2006
Organization subpart
No

Authorized official

Name
Dr. Christopher John Wolf, O.D. NPI 1174564173
Title
Owner
Phone
(574) 291-8900

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

4123 S Michigan St
South Bend, IN 46614
Phone (574) 291-8900

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 152W00000X 18001614 IN Yes

Addresses

Primary practice location

4123 S Michigan St
South Bend, IN 46614-2545

Mailing address

4123 S Michigan St
South Bend, IN 46614-2545
Phone (574) 291-8900

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023069283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4123 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142545",
            "telephone_number": "574-291-8900",
            "fax_number": "574-299-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142545",
            "telephone_number": "574-291-8900",
            "fax_number": "574-299-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER J. WOLF, OD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-291-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

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Sources for this page

Verify at the official NPI Registry.