Organization Active NPI

RX Optical Laboratories, Inc.

  • Optometrist
  • Angola, IN
National Provider Identifier
1144387986
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
RX OPTICAL LABORATORIES, INC.
Practice address
1400 N Wayne St Ste D
Angola, IN 46703-2359
Phone
(260) 668-8881
NPI assigned
Jan 2, 2007
Last updated
Dec 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Authorized official

Name
Stephan Jepson
Title
President
Phone
(269) 342-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

1400 N Wayne St Ste D
Angola, IN 46703-2359

Mailing address

1825 S Park St
Kalamazoo, MI 49001-2759

National Provider Directory

National Provider Directory

Locations

1400 N Wayne St
Ste D
Angola, IN 46703
Phone (260) 668-8881

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1144387986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 S PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490012759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N WAYNE ST STE D",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032359",
            "telephone_number": "260-668-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RX OPTICAL LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "JEPSON",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-342-0003"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.