NPIMap

Organization Active NPI

Eyecare Indiana LL, PC

  • Optometrist
  • Michigan City, IN
National Provider Identifier
1699031823
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECARE INDIANA LL, PC
Practice address
3701 Franklin Street
Michigan City, IN 46360-7310
Phone
(219) 872-8844
Fax
(219) 874-2872
NPI assigned
Apr 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Terri Peschke
Title
C.O.O.
Phone
(574) 291-9200

Specialties & licenses 1

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

Addresses

Primary practice location

3701 Franklin Street
Michigan City, IN 46360-7310

Mailing address

4121 S. Michigan Street
South Bend, IN 46614-2545
Phone (574) 291-9200

Other names 1

  • C&B Optical One Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CB Optical One11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3701 Franklin St
Michigan City, IN 46360
Phone (219) 872-8844

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1699031823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 S. MICHIGAN STREET",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142545",
            "telephone_number": "574-291-9200",
            "fax_number": "574-299-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 FRANKLIN STREET",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607310",
            "telephone_number": "219-872-8844",
            "fax_number": "219-874-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE INDIANA LL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "PESCHKE",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "574-291-9200"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C&B Optical One",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Michigan City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.