NPIMap

Organization Active NPI

Gunderson Eyecare P.C.

  • Optometrist
  • Jasper, IN
National Provider Identifier
1437102076
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
56000357A Issued in IN
Legal business name
GUNDERSON EYECARE P.C.
Practice address
255 W 36TH St
Suite 240
Jasper, IN 47546-7820
Phone
(812) 481-2100
Fax
(812) 481-2144
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Authorized official

Name
Dr. Kimberly L Gunderson, O.D.NPI 1548257926
Title
Optometrist
Phone
(812) 481-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 56000357A IN Primary

Addresses

Primary practice location

255 W 36TH St
Suite 240
Jasper, IN 47546-7820

Mailing address

255 W 36TH St
Suite 240
Jasper, IN 47546-7820
Phone (812) 481-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060608000263 IN Part B Supplier - Clinic/Group Practice 9537171699 Receives reassigned benefits from 2 practitioners
Practice locations: Jasper, IN
O20100930034986 IN DME Supplier - Physician - Optometrist 9537171699 Practice locations: Jasper, IN

National Provider Directory

National Provider Directory

Locations

3650 N Newton St
Jasper, IN 47546
Phone (812) 481-2100

255 W 36th St
Ste 240
Jasper, IN 47546
Phone (812) 481-2100

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ocuco_gundersoneyecare

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551139200000",
    "number": "1437102076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W 36TH ST",
            "address_2": "SUITE 240",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475467820",
            "telephone_number": "812-481-2100",
            "fax_number": "812-481-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W 36TH ST",
            "address_2": "SUITE 240",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475467820",
            "telephone_number": "812-481-2100",
            "fax_number": "812-481-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDERSON EYECARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-02-26",
        "status": "A",
        "authorized_official_last_name": "GUNDERSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "812-481-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "56000357A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.