Individual provider Active NPI

Taylor Welsh, OD

  • Optometrist
  • Bloomington, IN
National Provider Identifier
1134866734
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004354A Issued in IN
Practice address
2901 S McIntire Dr
Bloomington, IN 47403-4209
Phone
(812) 332-1401
NPI assigned
May 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 18004354A IN Primary

Addresses

Primary practice location

2901 S McIntire Dr
Bloomington, IN 47403-4209

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

980 Averitt Rd
Greenwood, IN 46143-9540
Phone (317) 881-4143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810002919 IN Practitioner - Optometry 0446633309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Indiana LLCGroup PAC ID 5496091316, 82 clinicians

Practice addresses (Care Compare)

2901 S McIntire Dr
Suite 120
Bloomington, IN 47403-4209
Phone (812) 332-1401

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Aug 8, 2022 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Aug 8, 2022 Accepting new patients

Locations

4719 W State Road 46
Bloomington, IN 47404
Phone (812) 876-2020

2901 S McIntire Dr
Bloomington, IN 47403
Phone (812) 332-1401

1105 S College Mall Rd
Bloomington, IN 47401
Phone (812) 333-2020

2901 S McIntire Dr
Ste 120
Bloomington, IN 47403
Phone (812) 332-1401

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

980 Averitt Rd
Greenwood, IN 46143
Phone (317) 881-4143

357 W Morgan St
Ste C
Spencer, IN 47460
Phone (812) 829-1254

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1134866734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "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": "2901 S MCINTIRE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034209",
            "telephone_number": "812-332-1401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "980 Averitt Rd",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461439540",
            "country_code": "US",
            "telephone_number": "317-881-4143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELSH",
        "first_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004354A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.