Kregg Koons O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002701 Issued in IN

Legal business name

KREGG KOONS O.D., INC.

Practice address

1608 W. McGalliard Rd.
Muncie, IN 47304

Phone

(765) 289-4727

Fax

(765) 751-2207

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kregg C Koons, O.D.

Title

President/Owner

Phone

(765) 289-4727

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Alan Lenig O.D., Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Kregg Koons O.D., Inc.

  • Optometrist
  • Anderson, IN
  • NPI 1447320668

  O20050115000021

  Same enrollment
• Kregg Koons O.D., Inc.

  • Optometrist
  • Muncie, IN
  • NPI 1902143456

  O20050115000021

  Same enrollment

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1508936725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 W. MCGALLIARD RD.",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47304",
            "telephone_number": "765-289-4727",
            "fax_number": "765-751-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 W. MCGALLIARD RD.",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47304",
            "telephone_number": "765-289-4727",
            "fax_number": "765-751-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KREGG KOONS O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "KOONS",
        "authorized_official_first_name": "KREGG",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "765-289-4727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10015240A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100376600",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alan Lenig O.D., Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Joseph A Koss, MD
• Amy Koza, LSW
• Frank Harold Krause, ED.D.,HSPP
• Lexi Grace Kreamelmeyer
• Kregg Koons O.D., Inc.
• Kregg Koons O.D., Inc.
• Kroger Limited Partnership I
• Kroger Limited Partnership I
• Theresa Anne Kruczek, PH.D.
• Kathryn E Kruse, PA-C

• Optometrist in Muncie, IN
• Providers in Muncie, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.