NPIMap

Organization Active NPI

Douglas a. Duerstock O.D. Inc.

  • Optometrist
  • Madison, IN
National Provider Identifier
1114258639
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002570B Issued in IN
Legal business name
DOUGLAS A. DUERSTOCK O.D. INC.
Practice address
567 Ivy Tech Dr
Madison, IN 47250-1802
Phone
(812) 273-6901
Fax
(812) 265-3275
NPI assigned
Jan 22, 2010
Last updated
Jan 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Authorized official

Name
Dr. Douglas A. Duerstock, O.D.NPI 1871695577
Title
Optometrist
Phone
(812) 273-6901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002570B IN Primary

Addresses

Primary practice location

567 Ivy Tech Dr
Madison, IN 47250-1802

Mailing address

567 Ivy Tech Dr
Madison, IN 47250-1802
Phone (812) 273-6901

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1114258639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 IVY TECH DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472501802",
            "telephone_number": "812-273-6901",
            "fax_number": "812-265-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 IVY TECH DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472501802",
            "telephone_number": "812-273-6901",
            "fax_number": "812-265-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS A. DUERSTOCK O.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "DUERSTOCK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "812-273-6901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002570B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.