Organization Active NPI

Midwest Eye Consultants, P.C.

  • Optometrist
  • Winchester, IN
National Provider Identifier
1578099438
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
54000164A Issued in IN
Legal business name
MIDWEST EYE CONSULTANTS, P.C.
Practice address
310 S Oak St
Winchester, IN 47394-2236
Phone
(260) 569-9550
Fax
(260) 569-0760
NPI assigned
May 11, 2017
Last updated
Jan 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MIDWEWEST EYE CONSULTANTS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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

Authorized official

Name
Gregory L Garner, ODNPI 1639139801
Title
President
Phone
(765) 833-5778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 54000164A IN Primary

Addresses

Primary practice location

310 S Oak St
Winchester, IN 47394-2236

Mailing address

PO Box 549
Wabash, IN 46992-0549
Phone (260) 569-9550

Other identifiers 1

IdentifierTypeStateIssuer
300007408MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302000158 IN Part B Supplier - Clinic/Group Practice 2961399217 Receives reassigned benefits from 100 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Midwest Eye Consultants PC

Practitioners & affiliated clinicians

Practitioners 1

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": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516060800000",
    "number": "1578099438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469920549",
            "telephone_number": "260-569-9550",
            "fax_number": "260-569-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S OAK ST",
            "city": "WINCHESTER",
            "state": "IN",
            "postal_code": "473942236",
            "telephone_number": "260-569-9550",
            "fax_number": "260-569-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE CONSULTANTS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWEWEST EYE CONSULTANTS, P.C.",
        "enumeration_date": "2017-05-11",
        "last_updated": "2018-01-16",
        "status": "A",
        "authorized_official_last_name": "GARNER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-833-5778",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "54000164A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007408",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.