Organization Active NPI

Steven R. Rutan, O.D., Inc

Doing business as Rutan Optometry Associates

  • Optometrist
  • Fort Wayne, IN
National Provider Identifier
1033185897
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
STEVEN R. RUTAN, O.D., INC
Doing business as
Rutan Optometry Associates
Practice address
5229 Coldwater Rd
Fort Wayne, IN 46825-5538
Phone
(260) 484-1453
Fax
(260) 483-8287
NPI assigned
Feb 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Steven Ray Rutan, O.D.
Title
President
Phone
(260) 484-1453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

5229 Coldwater Rd
Fort Wayne, IN 46825-5538

Mailing address

5229 Coldwater Rd
Fort Wayne, IN 46825-5538
Phone (260) 484-1453

Other identifiers 1

IdentifierTypeStateIssuer
100054070AMedicaidIN

Other names 1

  • Rutan Optometry Associates Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278374400000",
    "number": "1033185897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5229 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255538",
            "telephone_number": "260-484-1453",
            "fax_number": "260-483-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5229 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255538",
            "telephone_number": "260-484-1453",
            "fax_number": "260-483-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN R. RUTAN, O.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2010-07-06",
        "status": "A",
        "authorized_official_last_name": "RUTAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-484-1453",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100054070A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rutan Optometry Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.