Active NPI
Midwest Eye Consultants, P.C.
- Optometrist
- Winchester, IN
National Provider Identifier
1578099438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 54000164A
- 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, 2018
- Organization subpart
- Yes
- Parent organization
- MIDWEWEST EYE CONSULTANTS, P.C.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gregory L Garner, OD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300007408 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
- Optometrist
- Wabash, IN
- NPI 1639139801
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.