Southside Center for Sight

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

SOUTHSIDE CENTER FOR SIGHT

Practice address

701 E County Line Road
Suite 202
Greenwood, IN 46143-1071

Phone

(317) 215-2833

Fax

(317) 215-2838

NPI assigned

Sep 8, 2015

Last updated

Mar 31, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Bauer Pesavento, MDNPI 1285742163

Title

Owner

Phone

(317) 215-2833

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/medflow_southsidecenterforsight

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.

• Christopher Bauer Pesavento, M.D.

  • Ophthalmology Physician
  • Greenwood, IN
  • NPI 1285742163
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1205204377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE ROAD",
            "address_2": "SUITE 202",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431071",
            "telephone_number": "317-215-2833",
            "fax_number": "317-215-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE ROAD",
            "address_2": "SUITE 202",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431071",
            "telephone_number": "317-215-2833",
            "fax_number": "317-215-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE CENTER FOR SIGHT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-08",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "PESAVENTO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "BAUER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-215-2833",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shauna McDaniel Sorrell, M.A., CCC-SLP
• Kalee Sotelo, RBT
• Dararaeksmey Soun
• South Grove Eye Care, PC
• Rebecca South, RBT
• Southside Eye Center, P.C.
• Southside Foot Clinic P C
• Southside Pulmonary & Sleep Consultants, LLC
• Ashlin Spacht
• Shabrea Aushay Spafford I

• Ophthalmology Physician in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.