Individual provider Active NPI

Alan Lenig, OD

  • Optometrist
  • Muncie, IN
National Provider Identifier
1386757771
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001625B Issued in IN
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

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200047820AMedicaidIN

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

LicenseStateTypeSpecialty
18001625BINMDOptometrist

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.