NPIMap

Organization Active NPI

Eyecare Indiana LL, PC

Doing business as C&B Optical One

  • Optometrist
  • Lafayette, IN
National Provider Identifier
1346506573
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECARE INDIANA LL, PC
Doing business as
C&B Optical One
Practice address
12 Professional Court
Lafayette, IN 47905-5152
Phone
(765) 447-5083
Fax
(765) 448-4716
NPI assigned
Apr 2, 2012
Last updated
Apr 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Terri Peschke
Title
C.O.O.
Phone
(574) 291-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

12 Professional Court
Lafayette, IN 47905-5152

Mailing address

4121 S. Michigan Street
South Bend, IN 46614-2545
Phone (574) 291-9200

Other names 1

  • C&B Optical One Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CB Optical One11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1346506573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 S. MICHIGAN STREET",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142545",
            "telephone_number": "574-291-9200",
            "fax_number": "574-299-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PROFESSIONAL COURT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055152",
            "telephone_number": "765-447-5083",
            "fax_number": "765-448-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE INDIANA LL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "PESCHKE",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "574-291-9200"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C&B Optical One",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.