Active NPI
Alan Lenig, OD
- Optometrist
- Muncie, IN
National Provider Identifier
1386757771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18001625B
- Practice address
- 1608 West McGalliard Road
Muncie, IN 47304-2205 - Phone
- (765) 289-4727
- Fax
- (765) 751-2207
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18001625B | IN | Primary |
Addresses
Primary practice location
1608 West McGalliard Road
Muncie, IN 47304-2205
Mailing address
3300 W Fox Ridge LN
Muncie, IN 47304-5201
Phone (765) 289-4727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200047820A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18001625B | IN | MD | Optometrist |
Interoperability endpoints
- alan.lenig.1@21022.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1386757771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 W FOX RIDGE LN",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473045201",
"telephone_number": "765-289-4727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1608 WEST MCGALLIARD ROAD",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473042205",
"telephone_number": "765-289-4727",
"fax_number": "765-751-2207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LENIG",
"first_name": "ALAN",
"name_prefix": "Mr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18001625B",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200047820A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.