NPIMap

Organization Active NPI

One Source Vision Care

  • Optometrist
  • Boonville, IN
National Provider Identifier
1437463288
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001663A Issued in IN
Legal business name
ONE SOURCE VISION CARE
Practice address
966 Aigner Dr
Boonville, IN 47601-8471
Phone
(812) 897-8900
Fax
(801) 218-0060
NPI assigned
Aug 4, 2010
Last updated
Sep 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Authorized official

Name
Dr. David N Phillips, O.D.
Title
President
Phone
(812) 897-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 18001663A IN Primary

Addresses

Primary practice location

966 Aigner Dr
Boonville, IN 47601-8471

Mailing address

966 Aigner Dr
Boonville, IN 47601-8471
Phone (812) 897-8900

National Provider Directory

National Provider Directory

Locations

966 Aigner Dr
Boonville, IN 47601
Phone (812) 897-8900

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1437463288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 AIGNER DR",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476018471",
            "telephone_number": "812-897-8900",
            "fax_number": "801-218-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 AIGNER DR",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476018471",
            "telephone_number": "812-897-8900",
            "fax_number": "801-218-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE SOURCE VISION CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-04",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-897-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001663A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.