NPIMap

Organization Active NPI

Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Columbus, IN
National Provider Identifier
1376166629
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF INDIANA, LLC
Practice address
1130 Washington St
Columbus, IN 47201-5720
Phone
(812) 379-9893
Fax
(812) 379-9904
NPI assigned
May 21, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Sue Downes
Title
Secretary
Phone
(703) 847-8899

Corporate family (same tax ID) 49

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

View all 49

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2292432Myeyedr Optometry of Indiana, LLC1130 Washington St, Columbus, IN 47201Certificate of waiverOct 24, 2027

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20190115001215 IN Part B Supplier - Clinic/Group Practice 5496091316 Receives reassigned benefits from 157 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Myeyedr Optometry of in LLC (50 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1130 Washington St
Columbus, IN 47201-5720

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

NPPES NPI Registry
  • MyEyeDr. Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 28, 2025.

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1376166629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 WASHINGTON ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015720",
            "telephone_number": "812-379-9893",
            "fax_number": "812-379-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-21",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "DOWNES",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.