Quality Optical Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

QUALITY OPTICAL INC

Practice address

424 N Main St
Suite 4
Middlebury, IN 46540-8988

Phone

(574) 825-3818

Fax

(574) 825-9497

NPI assigned

Mar 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David R Fenwick, O.D.NPI 1104899426

Title

Owner

Phone

(574) 825-3818

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Quality Optical Inc

  • Optometrist
  • Plymouth, IN
  • NPI 1801845995

  O20080328000066

  Same enrollment

Practitioners 1

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

• David Fenwick

  • Optometrist
  • Middlebury, IN
  • NPI 1104899426

  IN

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1689635831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465408988",
            "telephone_number": "574-825-3818",
            "fax_number": "574-825-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465408988",
            "telephone_number": "574-825-3818",
            "fax_number": "574-825-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "FENWICK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-825-3818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100325370",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Middlebury, IN
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.