Organization Active NPI

Nappanee Family Eyecare, P.C.

  • Optometrist
  • Nappanee, IN
National Provider Identifier
1083781512
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002832 Issued in IN
Legal business name
NAPPANEE FAMILY EYECARE, P.C.
Practice address
1752 E Market St
Nappanee, IN 46550-9216
Phone
(574) 773-4341
Fax
(574) 773-2324
NPI assigned
Nov 29, 2006
Last updated
Jun 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Dr. Darren L Minnich, O.D.NPI 1043292048
Title
Owner
Phone
(574) 773-4341

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002832 IN Primary

Addresses

Primary practice location

1752 E Market St
Nappanee, IN 46550-9216

Mailing address

1752 E Market St
Nappanee, IN 46550-9216
Phone (574) 773-4341

Other identifiers 1

IdentifierTypeStateIssuer
200095640MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100914001167 IN Part B Supplier - Clinic/Group Practice 9830214832 Receives reassigned benefits from 6 practitioners
Practice locations: Nappanee, IN
O20100930087642 IN DME Supplier - Physician - Optometrist 9830214832 Practice locations: Nappanee, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2041606Nappanee Family Eyecare1752 E Market St, Nappanee, IN 46550Certificate of waiverMay 24, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Nappanee Family Eyecare PC1752 E Market St, Nappanee, IN 46550-9216(574) 773-4341 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2003

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1083781512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 E MARKET ST",
            "city": "NAPPANEE",
            "state": "IN",
            "postal_code": "465509216",
            "telephone_number": "574-773-4341",
            "fax_number": "574-773-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 E MARKET ST",
            "city": "NAPPANEE",
            "state": "IN",
            "postal_code": "465509216",
            "telephone_number": "574-773-4341",
            "fax_number": "574-773-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAPPANEE FAMILY EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "MINNICH",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-773-4341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200095640",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nappanee, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.