NPIMap

Organization Active NPI

Richard J Peach OD Inc

  • Optometrist
  • Munster, IN
National Provider Identifier
1356482798
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001668A Issued in IN
Legal business name
RICHARD J PEACH OD INC
Practice address
800 Macarthur Blvd
Suite 10
Munster, IN 46321-2917
Phone
(219) 836-5326
Fax
(219) 836-5326
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Authorized official

Name
Dr. Richard J Peach, O.D.
Title
President
Phone
(219) 836-5326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 18001668A IN Primary

Addresses

Primary practice location

800 Macarthur Blvd
Suite 10
Munster, IN 46321-2917

Mailing address

800 Macarthur Blvd
Suite 10
Munster, IN 46321-2917
Phone (219) 836-5326

Other identifiers 1

IdentifierTypeStateIssuer
0509220001OtherINDMERC

National Provider Directory

National Provider Directory

Locations

800 MacArthur Blvd
Ste 10
Munster, IN 46321
Phone (219) 836-5326

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352764800000",
    "number": "1356482798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MACARTHUR BLVD",
            "address_2": "SUITE 10",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212917",
            "telephone_number": "219-836-5326",
            "fax_number": "219-836-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MACARTHUR BLVD",
            "address_2": "SUITE 10",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212917",
            "telephone_number": "219-836-5326",
            "fax_number": "219-836-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD J PEACH OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2012-11-13",
        "status": "A",
        "authorized_official_last_name": "PEACH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-836-5326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001668A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0509220001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.