Organization Active NPI

James D. Ferguson OD PC

Doing business as Family Eyecare Center

  • Optometrist
  • Highland, IN
National Provider Identifier
1427358209
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002583A Issued in IN
Legal business name
JAMES D. FERGUSON OD PC
Doing business as
Family Eyecare Center
Practice address
8417 Kennedy Ave
Highland, IN 46322-1139
Phone
(219) 838-2020
Fax
(219) 838-0454
NPI assigned
Oct 27, 2010
Last updated
Oct 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
Debra Smith
Title
Billing Manager
Phone
(219) 972-0904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 18002583A IN Primary

Addresses

Primary practice location

8417 Kennedy Ave
Highland, IN 46322-1139

Mailing address

8417 Kennedy Ave
Highland, IN 46322-1139
Phone (219) 838-2020

Other identifiers 1

IdentifierTypeStateIssuer
200323790MedicaidIN

Other names 1

  • Family Eyecare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101013000546 IN Part B Supplier - Clinic/Group Practice 2264645043 Receives reassigned benefits from 2 practitioners
Practice locations: East Chicago, IN; Highland, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1427358209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8417 KENNEDY AVE",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221139",
            "telephone_number": "219-838-2020",
            "fax_number": "219-838-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8417 KENNEDY AVE",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221139",
            "telephone_number": "219-838-2020",
            "fax_number": "219-838-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES D. FERGUSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "219-972-0904"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002583A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200323790",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eyecare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Highland, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.