Organization Active NPI

Marcia J. Monroe,O.D.,Inc

  • Optometrist
  • Seymour, IN
National Provider Identifier
1346422474
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002155B Issued in IN
Legal business name
MARCIA J. MONROE,O.D.,INC
Practice address
915 W Brown St
Seymour, IN 47274-2715
Phone
(812) 522-8777
Fax
(812) 524-0042
NPI assigned
Nov 30, 2007
Last updated
Nov 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Authorized official

Name
Marcia J. Monroe,O.D.,Inc, O.D.
Title
President
Phone
(812) 522-8777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 18002155B IN Primary

Addresses

Primary practice location

915 W Brown St
Seymour, IN 47274-2715

Mailing address

915 W Brown St
Seymour, IN 47274-2715
Phone (812) 522-8777

Other identifiers 3

IdentifierTypeStateIssuer
200390280AMedicaidIN
193260AOtherINMEDICARE
HO9075OtherINARNETT CLARION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111219000360 IN Part B Supplier - Clinic/Group Practice 3870707953 Receives reassigned benefits from 1 practitioner
Practice locations: Seymour, IN

National Provider Directory

National Provider Directory

Locations

114 Executive Dr
Ste C
Lafayette, IN 47905
Phone (765) 442-1775

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1346422474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W BROWN ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742715",
            "telephone_number": "812-522-8777",
            "fax_number": "812-524-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W BROWN ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742715",
            "telephone_number": "812-522-8777",
            "fax_number": "812-524-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCIA J. MONROE,O.D.,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "MONROE,O.D.,INC",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-522-8777",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002155B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200390280A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "193260A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNETT CLARION",
            "identifier": "HO9075",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.