NPIMap

Organization Active NPI

Professional Eyecare Management, LLC

  • Optometrist
  • Evansville, IN
National Provider Identifier
1124170964
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PROFESSIONAL EYECARE MANAGEMENT, LLC
Practice address
634 Cross Valley Cir
Evansville, IN 47710-5238
Phone
(812) 426-2256
Fax
(812) 429-0392
NPI assigned
Jan 18, 2007
Last updated
Nov 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Authorized official

Name
Jeffrey D. Irvin, O.D.NPI 1013025683
Title
Owner
Phone
(812) 426-2256

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X IN Primary

Addresses

Primary practice location

634 Cross Valley Cir
Evansville, IN 47710-5238

Mailing address

634 Cross Valley Cir
Evansville, IN 47710-5238
Phone (812) 426-2256

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1124170964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 CROSS VALLEY CIR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477105238",
            "telephone_number": "812-426-2256",
            "fax_number": "812-429-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 CROSS VALLEY CIR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477105238",
            "telephone_number": "812-426-2256",
            "fax_number": "812-429-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYECARE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "IRVIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-426-2256",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.