Eye Center Group LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYE CENTER GROUP LLC

Practice address

3631 N Morrison Rd
Muncie, IN 47304-5547

Phone

(765) 286-8888

Fax

(765) 747-7962

NPI assigned

Feb 15, 2008

Organization subpart

No

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

Authorized official

Name

Dorian F Winconek

Title

Ceo

Phone

(765) 286-8888

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Morrison Eye Center Doing business as

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1043488778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 472",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473080472",
            "telephone_number": "765-286-8888",
            "fax_number": "765-747-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 N MORRISON RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045547",
            "telephone_number": "765-286-8888",
            "fax_number": "765-747-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTER GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "WINCONEK",
        "authorized_official_first_name": "DORIAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-286-8888"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100339260S",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morrison Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eye Specialists Surgery Centers, LLC

• Optometrist in Muncie, IN
• Providers in Muncie, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.