Organization Active NPI

Joseph M. Thallemer, O.D., P.C.

  • Optometrist
  • Warsaw, IN
National Provider Identifier
1265587034
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JOSEPH M. THALLEMER, O.D., P.C.
Practice address
3301 E Center Street Ext
Warsaw, IN 46582-3909
Phone
(574) 269-3828
Fax
(574) 269-3848
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Authorized official

Name
Dr. Joseph Michael Thallemer, O.D.
Title
Owner
Phone
(574) 269-3828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3301 E Center Street Ext
Warsaw, IN 46582-3909

Mailing address

3301 E Center Street Ext
Warsaw, IN 46582-3909
Phone (574) 269-3828

Other identifiers 1

IdentifierTypeStateIssuer
200372990MedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1265587034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 E CENTER STREET EXT",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465823909",
            "telephone_number": "574-269-3828",
            "fax_number": "574-269-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 E CENTER STREET EXT",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465823909",
            "telephone_number": "574-269-3828",
            "fax_number": "574-269-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M. THALLEMER, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "THALLEMER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-269-3828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200372990",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.