NPIMap

Organization Active NPI

Sugar Creek Eyecare, P.C.

  • Optometrist
  • Crawfordsville, IN
National Provider Identifier
1144499013
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002838A Issued in IN
Legal business name
SUGAR CREEK EYECARE, P.C.
Practice address
109 E Main St
Crawfordsville, IN 47933-1710
Phone
(765) 362-2706
Fax
(765) 362-2985
NPI assigned
Feb 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Angela K Giles
Title
Accounts Manager
Phone
(765) 362-2706

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 18002838A IN Primary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X 18002838A IN
Low Vision Rehabilitation OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WL0500X 18002838A IN
Pediatric OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WP0200X 18002838A IN

Addresses

Primary practice location

109 E Main St
Crawfordsville, IN 47933-1710

Mailing address

109 E Main St
Crawfordsville, IN 47933-1710
Phone (765) 362-2706

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111212000827 IN Part B Supplier - Clinic/Group Practice 2365617867 Receives reassigned benefits from 2 practitioners
Practice locations: Crawfordsville, IN

National Provider Directory

National Provider Directory

Locations

109 E Main St
Crawfordsvlle, IN 47933
Phone (765) 362-2706

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": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1144499013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E MAIN ST",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479331710",
            "telephone_number": "765-362-2706",
            "fax_number": "765-362-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E MAIN ST",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479331710",
            "telephone_number": "765-362-2706",
            "fax_number": "765-362-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGAR CREEK EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "GILES",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "765-362-2706"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002838A",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IN",
            "license": "18002838A",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "IN",
            "license": "18002838A",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "IN",
            "license": "18002838A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crawfordsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.