Active NPI
Kurt S. Petry OD, PC
Doing business as Spencer Community Eyecare
- Optometrist
- Spencer, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18002244B
- Legal business name
- KURT S. PETRY OD, PC
- Doing business as
- Spencer Community Eyecare
- Practice address
- 357C W Morgan St
Spencer, IN 47460-1219 - Phone
- (812) 829-2972
- NPI assigned
- May 21, 2008
- Last updated
- Mar 1, 2010
- Organization subpart
- Yes
- Parent organization
- KURT S. PETRY OD, PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kurt S Petry, O.D.
- Title
- President
- Phone
- (812) 829-2972
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18002244B | IN | Primary |
Addresses
Primary practice location
357C W Morgan St
Spencer, IN 47460-1219
Mailing address
357C W Morgan St
Spencer, IN 47460-1219
Phone (812) 829-2972
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000087919 | Other | IN | BCBS |
| 100193710 | Medicaid | IN |
Other names 1
- Spencer Community Eyecare
National Provider Directory
National Provider Directory- Part of
- Franklin Community Eyec
Locations
5455 Harrison Park Ln
Indianapolis, IN 46216
Phone (317) 802-1164
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.
-
- Optometrist
- Spencer, IN
- NPI 1578637658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1267401600000",
"number": "1144487638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "357C W MORGAN ST",
"city": "SPENCER",
"state": "IN",
"postal_code": "474601219",
"telephone_number": "812-829-2972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "357C W MORGAN ST",
"city": "SPENCER",
"state": "IN",
"postal_code": "474601219",
"telephone_number": "812-829-2972"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KURT S. PETRY OD, PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KURT S. PETRY OD, PC",
"enumeration_date": "2008-05-21",
"last_updated": "2010-03-01",
"status": "A",
"authorized_official_last_name": "PETRY",
"authorized_official_first_name": "KURT",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "812-829-2972",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18002244B",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000087919",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100193710",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Spencer Community Eyecare",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Spencer, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.