Individual provider Active NPI

John Lawrence, OD

  • Optometrist
  • Muncie, IN
National Provider Identifier
1609438423
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004197A Issued in IN
Practice address
3300 W Purdue Ave
Muncie, IN 47304-6355
Phone
(765) 288-1935
NPI assigned
Jul 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004197B IN
Optometrist 152W00000X 18004197A IN Primary

Addresses

Primary practice location

3300 W Purdue Ave
Muncie, IN 47304-6355

Mailing address

220 E Oldfield LN Apt H
Muncie, IN 47303-5928

Other practice location 1

1540 Spring Valley Dr
Huntington, WV 25704-9300
Phone (304) 429-6741

Other practice location 2

3300 W Fox Ridge Ln
Muncie, IN 47304-5201
Phone (765) 289-4727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210331000814 IN Practitioner - Optometry 0042627499 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kregg Koons OD IncGroup PAC ID 5698724706, 3 clinicians
Vasilis Makris, MD PCGroup PAC ID 8022006162, 2 clinicians

Practice addresses (Care Compare)

3300 W Fox Ridge LN
Muncie, IN 47304-5201
Phone (765) 289-4727

3300 W Purdue Ave
Muncie, IN 47304-6355
Phone (765) 288-1935

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004197AINMDOptometrist
18004197BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kregg Koons O.D., Inc. Optometrist CurrentSince Dec 30, 2020 Accepting new patients
Kregg Koons O.D., Inc. Optometrist CurrentSince Dec 30, 2020 Accepting new patients

Locations

3300 W Fox Ridge Ln
Muncie, IN 47304
Phone (765) 289-4727

3300 W Purdue Ave
Muncie, IN 47304
Phone (765) 287-9579

Interoperability endpoints

  • Direct secure messaging: dr.lawrence@makris.emadirect.md

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1609438423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E OLDFIELD LN APT H",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473035928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046355",
            "telephone_number": "765-288-1935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Spring Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257049300",
            "country_code": "US",
            "telephone_number": "304-429-6741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 W Fox Ridge Ln",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473045201",
            "country_code": "US",
            "telephone_number": "765-289-4727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "JOHN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2022-03-15",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004197B",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004197A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.