NPIMap

Organization Active NPI

Eye Associates of Southern Indiana PC

  • Eyewear Supplier
  • Jeffersonville, IN
National Provider Identifier
1285012435
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYE ASSOCIATES OF SOUTHERN INDIANA PC
Practice address
1407 Spring St
Suite 1
Jeffersonville, IN 47130-3748
Phone
(812) 284-0660
Fax
(812) 284-3822
NPI assigned
May 8, 2015
Last updated
May 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Authorized official

Name
Ronda Boman
Title
Insurance Director
Phone
(812) 590-6157

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

1407 Spring St
Suite 1
Jeffersonville, IN 47130-3748

Mailing address

1407 Spring St
Suite 1
Jeffersonville, IN 47130-3748
Phone (812) 284-0660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150910002478 IN DME Supplier - Physician - Ophthalmology 4183688310 Practice locations: Jeffersonville, IN

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Eye Associates of South10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1407 Spring St
Ste 1
Jeffersonvlle, IN 47130
Phone (812) 282-4844

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1285012435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 SPRING ST",
            "address_2": "SUITE 1",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303748",
            "telephone_number": "812-284-0660",
            "fax_number": "812-284-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 SPRING ST",
            "address_2": "SUITE 1",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303748",
            "telephone_number": "812-284-0660",
            "fax_number": "812-284-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF SOUTHERN INDIANA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-08",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "BOMAN",
        "authorized_official_first_name": "RONDA",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "812-590-6157"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.