Individual provider Active NPI

Sally R. Poling, O.D.

  • Optometrist
  • Greenwood, IN
National Provider Identifier
1215043799
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002232 Issued in IN
Practice address
1133 N Emerson Ave
Greenwood, IN 46143-6275
Phone
(317) 888-9038
Fax
(317) 888-9079
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002232 IN Primary

Addresses

Primary practice location

1133 N Emerson Ave
Greenwood, IN 46143-6275

Mailing address

6580 W Lowell Rd
Columbus, IN 47201-4648
Phone (812) 379-9082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160518001707 IN Practitioner - Optometry 6002105822 Reassigns benefits to 1 organization
Practice locations: Greenwood, IN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Impressions Optometric Associates, LLC 30 clinicians

Practice addresses (Care Compare)

10777 E Washington St
Suite a Visionworks Doctors of Optometry
Indianapolis, IN 46229-2642
Phone (317) 897-0480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002232INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
First Impressions Optometric Associates, LLC Optometrist CurrentSince Feb 6, 2022 Accepting new patients
First Impressions Optometric Associates, LLC Optometrist CurrentSince Feb 6, 2022 Accepting new patients
First Impressions Optometric Associates, LLC Optometrist Past Accepting new patients
First Impressions Optometric Associates, LLC Optometrist Past Accepting new patients

Locations

1030 Veterans Pkwy
Clarksville, IN 47129
Phone (812) 282-2020

11781 Commercial Dr
Fishers, IN 46038
Phone (317) 513-3234

1251 US Highway 31 N
Ste K3A
Greenwood, IN 46142
Phone (317) 883-0419

10777 E Washington St
Ste A
Indianapolis, IN 46229
Phone (317) 397-0480

2141 Sagamore Pkwy S
Lafayette, IN 47905
Phone (765) 446-8010

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1215043799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6580 W LOWELL RD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472014648",
            "telephone_number": "812-379-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 N EMERSON AVE",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436275",
            "telephone_number": "317-888-9038",
            "fax_number": "317-888-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLING",
        "first_name": "SALLY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.