Individual provider Active NPI

Marjorie J. Knotts, O.D.

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1447303755
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002141B Issued in IN
Practice address
6326 Rucker Rd
Suite C
Indianapolis, IN 46220-4889
Phone
(317) 259-4234
Fax
(317) 259-1538
NPI assigned
Jan 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002141B IN Primary

Addresses

Primary practice location

6326 Rucker Rd
Suite C
Indianapolis, IN 46220-4889

Mailing address

6326 Rucker Rd
Suite C
Indianapolis, IN 46220-4889
Phone (317) 259-4234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100918000007 IN Practitioner - Optometry 4880719582 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002141BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marjorie J. Knotts, O.D., Inc Optometrist CurrentSince Nov 1, 1989 Accepting new patients

Locations

6326 Rucker Rd
Ste C
Indianapolis, IN 46220
Phone (317) 257-4444

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447303755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6326 RUCKER RD",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204889",
            "telephone_number": "317-259-4234",
            "fax_number": "317-259-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 RUCKER RD",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204889",
            "telephone_number": "317-259-4234",
            "fax_number": "317-259-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOTTS",
        "first_name": "MARJORIE",
        "middle_name": "J.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002141B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.