Organization Active NPI

Myeyedr Optometry of Indiana, LLC

Doing business as MyEyeDr.

  • Optometrist
  • Fishers, IN
National Provider Identifier
1114413408
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF INDIANA, LLC
Doing business as
MyEyeDr.
Practice address
11720 Olio Rd
Fishers, IN 46037-7623
Phone
(317) 570-2778
Fax
(317) 570-2774
NPI assigned
Jul 10, 2018
Last updated
May 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Authorized official

Name
Sue Downs
Title
Secretary
Phone
(703) 847-8899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

11720 Olio Rd
Fishers, IN 46037-7623

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • MyEyeDr. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190115001215 IN Part B Supplier - Clinic/Group Practice 5496091316 Receives reassigned benefits from 157 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

11720 Olio Rd
Fishers, IN 46037
Phone (317) 570-2778

Practitioners & affiliated clinicians

Practitioners 2

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": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1114413408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11720 OLIO RD",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377623",
            "telephone_number": "317-570-2778",
            "fax_number": "317-570-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "DOWNS",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.