Kregg Koons O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002701 Issued in IN

Legal business name

KREGG KOONS O.D., INC.

Practice address

3300 Purdue Ave.
Muncie, IN 47304

Phone

(765) 288-1935

NPI assigned

Jun 22, 2018

Last updated

Jun 22, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

KREGG KOONS O.D., INC.As reported in NPPES

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

Authorized official

Name

Kregg C Koons, ODNPI 1962515791

Title

Owner

Phone

(765) 289-4727

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Kregg Koons O.D., Inc.

  • Optometrist
  • Muncie, IN
  • NPI 1902143456

  5698724706

  Same PAC ID

Tax ID family

Alan Lenig OD Inc3 organizations share this tax ID, including this one

Part of

Alan Lenig OD Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Kregg Koons O.D., Inc.

  • Optometrist
  • Anderson, IN
  • NPI 1215274626
  NPD tax ID
• Kregg Koons O.D., Inc.

  • Optometrist
  • Muncie, IN
  • NPI 1902143456
  NPD tax ID

Locations

Practitioners 3

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.

• Kregg C Koons, OD OPTOMETRY

  • Optometrist
  • Muncie, IN
  • NPI 1962515791
  NPD (past) Authorized official
• Jessica Michelle Davis, OD

  • Optometrist
  • Anderson, IN
  • NPI 1467713594
  NPD
• John Lawrence, OD

  • Optometrist
  • Muncie, IN
  • NPI 1609438423
  NPD

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529625600000",
    "number": "1235624289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W FOX RIDGE LN",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045201",
            "telephone_number": "765-289-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 PURDUE AVE.",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47304",
            "telephone_number": "765-288-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KREGG KOONS O.D., INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KREGG KOONS O.D., INC.",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A",
        "authorized_official_last_name": "KOONS",
        "authorized_official_first_name": "KREGG",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-289-4727",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100376600",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Koselke, PHARM.D.
• Joseph A Koss, MD
• Amy Koza, LSW
• Frank Harold Krause, ED.D.,HSPP
• Lexi Grace Kreamelmeyer
• Kregg Koons O.D., Inc.
• Kregg Koons O.D., Inc.
• Kroger Limited Partnership I (Kroger Pharmacy #336)
• Kroger Limited Partnership I
• Theresa Anne Kruczek, PH.D.

• Optometrist in Muncie, IN
• Providers in Muncie, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; 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.