Philip H. Nowak, O.D., P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002922 Issued in IN

Legal business name

PHILIP H. NOWAK, O.D., P.C.

Practice address

410 Grand Valley Blvd
Martinsville, IN 46151-6123

Phone

(800) 353-5420

Fax

(812) 331-8049

NPI assigned

Nov 14, 2011

Organization subpart

No

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

Authorized official

Name

Philip H Nowak, ODNPI 1649387432

Title

OD/Owner

Phone

(800) 353-5420

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

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

• Philip H Nowak, OD

  • Optometrist
  • Martinsville, IN
  • NPI 1649387432
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1376820795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1721",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461510721",
            "telephone_number": "800-353-5420",
            "fax_number": "812-331-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 GRAND VALLEY BLVD",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461516123",
            "telephone_number": "800-353-5420",
            "fax_number": "812-331-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP H. NOWAK, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "NOWAK",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "800-353-5420",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rolan A Pascual, MD
• Kenisha Renee Peden, LCSW
• Benjamin Phan, DDS
• Emma Phelps
• Michael Anthony Phelps, D.C.
• Pinnacle Treatment Centers in-I, LLC (Recovery Works Morgan)
• Pinnacle Treatment Centers in-I, LLC (Recovery Works Martinsville)
• Pinnacle Treatment Centers in-II, LLC (Martinsville Treatment Services)
• Giesla Potter, RDN
• Proactive Mso, LLC (Municipal Health Center)

• Optometrist in Martinsville, IN
• Providers in Martinsville, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.