Organization Active NPI

Fallen Timbers Family Eye Care

  • Optometrist
  • Maumee, OH
National Provider Identifier
1609022755
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5098 Issued in OH
Legal business name
FALLEN TIMBERS FAMILY EYE CARE
Practice address
3100 Main St
Suite #723
Maumee, OH 43537-9867
Phone
(419) 878-2628
Fax
(419) 878-2546
NPI assigned
Aug 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Authorized official

Name
Dr. Neerja Jindal, ODNPI 1417063082
Title
Optometrist
Phone
(419) 878-2628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5098 OH Primary

Addresses

Primary practice location

3100 Main St
Suite #723
Maumee, OH 43537-9867

Mailing address

3100 Main St
Suite #723
Maumee, OH 43537-9867
Phone (419) 878-2628

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080825000314 OH Part B Supplier - Clinic/Group Practice 1254406317 Receives reassigned benefits from 4 practitioners
Practice locations: Maumee, OH; Toledo, OH

National Provider Directory

National Provider Directory

Locations

3100 Main St
Ste 723
Maumee, OH 43537
Phone (419) 878-2628

5001 Monroe St
#T2
Toledo, OH 43623
Phone (419) 475-7908

5001 Monroe St
Ste 206
Toledo, OH 43623
Phone (419) 475-7908

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1609022755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MAIN ST",
            "address_2": "SUITE #723",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379867",
            "telephone_number": "419-878-2628",
            "fax_number": "419-878-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MAIN ST",
            "address_2": "SUITE #723",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379867",
            "telephone_number": "419-878-2628",
            "fax_number": "419-878-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLEN TIMBERS FAMILY EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "JINDAL",
        "authorized_official_first_name": "NEERJA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "419-878-2628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.