NPIMap

Organization Active NPI

Clarkson Optometry Midwest Inc

Doing business as Clarkson Eyecare

  • Optometrist
  • Clarksville, IN
National Provider Identifier
1295772143
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CLARKSON OPTOMETRY MIDWEST INC
Doing business as
Clarkson Eyecare
Practice address
325 E Lewis and Clark Pkwy Ste 200
Clarksville, IN 47129-1725
Phone
(636) 200-4393
Fax
(636) 527-0766
NPI assigned
Jun 1, 2006
Last updated
May 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
James WachterNPI 1689670697
Title
Cmo
Phone
(636) 200-4393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

325 E Lewis and Clark Pkwy Ste 200
Clarksville, IN 47129-1725

Mailing address

PO Box 207170
Dallas, TX 75320-7156
Phone (636) 200-4393

Other identifiers 2

IdentifierTypeStateIssuer
77903979MedicaidKY
200312790AMedicaidIN

Other names 1

  • Clarkson Eyecare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190327002362 IN Part B Supplier - Clinic/Group Practice 0749504165 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Clarksville, IN

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1420 Blackiston Mill Rd
Ste A
Clarksville, IN 47129
Phone (812) 288-2029

109 W 5th St
Benton, KY 42025
Phone (270) 527-7421

43 Industrial Pkwy
Calvert City, KY 42029
Phone (270) 395-8331

1709 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 765-2020

2000 Tunnel Hill Rd
Elizabethtown, KY 42701
Phone (270) 304-2520

1400 Commonwealth Dr
Mayfield, KY 42066
Phone (270) 247-2417

1750 Broadway St
Paducah, KY 42001
Phone (270) 442-2744

60 Lakeview Dr
Paducah, KY 42001
Phone (270) 554-2000

11919 Montgomery Rd
Cincinnati, OH 45249
Phone (513) 583-8970

441 Vine St
Ste 1C
Cincinnati, OH 45202
Phone (513) 721-6790

8118 Montgomery Rd
Cincinnati, OH 45236
Phone (513) 891-9030

3760 Rocky River Dr
Cleveland, OH 44111
Phone (216) 941-3303

280 N High St
Fl 1
Columbus, OH 43215
Phone (614) 221-8090

4864 W Broad St
Columbus, OH 43228
Phone (614) 224-2414

553 E Town St
Ste 1
Columbus, OH 43215
Phone (614) 461-1885

530 Wessel Dr
Ste G
Fairfield, OH 45014
Phone (513) 829-4600

83 N Hamilton Rd
Gahanna, OH 43230
Phone (614) 471-0313

10539 Harrison Ave
Harrison, OH 45030
Phone (513) 367-6199

6044 Parkmeadow Ln
Hilliard, OH 43026
Phone (614) 876-2686

6060 Rockside Woods Blvd N
Ste 110
Independence, OH 44131
Phone (216) 581-8484

21014 Center Ridge Rd
Rocky River, OH 44116
Phone (440) 331-4644

33790 Bainbridge Rd
Solon, OH 44139
Phone (330) 637-0348

34302 Euclid Ave
Unit 3
Willoughby Hills, OH 44094
Phone (440) 942-3677

890 High St
Ste A
Worthington, OH 43085
Phone (614) 885-7997

Practitioners & affiliated clinicians

Practitioners 59

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.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1295772143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207156",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E LEWIS AND CLARK PKWY STE 200",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471291725",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSON OPTOMETRY MIDWEST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77903979",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200312790A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarkson Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.