Organization Active NPI

Valley Optical II Inc

  • Optician
  • Washington, IN
National Provider Identifier
1508962804
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
VALLEY OPTICAL II INC
Practice address
400 E National Hwy
Washington, IN 47501-0798
Phone
(812) 254-6594
Fax
(812) 254-4099
NPI assigned
Sep 15, 2006
Last updated
Nov 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Authorized official

Name
Mr. Howard Dwaine Conard
Title
Owner
Phone
(812) 829-2291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X NU Primary

Addresses

Primary practice location

400 E National Hwy
Washington, IN 47501-0798

Mailing address

PO Box 798
400 E National Hwy
Washington, IN 47501-0798
Phone (812) 254-6594

Other identifiers 1

IdentifierTypeStateIssuer
200046280AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930001908 IN DME Supplier - Physician - Optometrist 7113045287 Practice locations: Washington, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Valley Optical II Inc400 E National Hwy, Washington, IN 47501-4114(812) 254-6594 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

400 E National Hwy
Washington, IN 47501
Phone (812) 254-1276

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": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1508962804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 798",
            "address_2": "400 E NATIONAL HWY",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475010798",
            "telephone_number": "812-254-6594",
            "fax_number": "812-254-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E NATIONAL HWY",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475010798",
            "telephone_number": "812-254-6594",
            "fax_number": "812-254-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY OPTICAL II INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "CONARD",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "DWAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-829-2291",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200046280A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.