NPIMap

Organization Active NPI

Marion Family Optometrists, Inc.

Doing business as Family Optometry

  • Optometrist
  • Wabash, IN
National Provider Identifier
1144650680
Registry record updated Dec 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003449 Issued in IN
Legal business name
MARION FAMILY OPTOMETRISTS, INC.
Doing business as
Family Optometry
Practice address
520 Manchester Ave
Wabash, IN 46992-1415
Phone
(260) 563-0884
Fax
(260) 563-3284
NPI assigned
Nov 20, 2013
Last updated
Dec 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2013

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

Authorized official

Name
Dr. Eric Dale, ODNPI 1669664363
Title
Vice President
Phone
(260) 563-0884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003449 IN Primary
Optometrist 152W00000X 18001734 IN

Addresses

Primary practice location

520 Manchester Ave
Wabash, IN 46992-1415

Mailing address

520 Manchester Ave
Wabash, IN 46992-1415
Phone (260) 563-0884

Other identifiers 1

IdentifierTypeStateIssuer
100253710BMedicaidIN

Other names 1

  • Family Optometry Doing business as

National Provider Directory

National Provider Directory

Locations

2855 Northpark Ave
Huntington, IN 46750
Phone (260) 200-1145

520 Manchester Ave
Wabash, IN 46992
Phone (260) 563-0884

Practitioners & affiliated clinicians

Practitioners 11

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": "1384905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388102400000",
    "number": "1144650680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MANCHESTER AVE",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921415",
            "telephone_number": "260-563-0884",
            "fax_number": "260-563-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MANCHESTER AVE",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921415",
            "telephone_number": "260-563-0884",
            "fax_number": "260-563-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION FAMILY OPTOMETRISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-20",
        "last_updated": "2013-12-27",
        "status": "A",
        "authorized_official_last_name": "DALE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "260-563-0884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003449",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001734",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100253710B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wabash, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; 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.