Julie S. Didat O.D P.S.C

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002547A Issued in IN

Legal business name

JULIE S. DIDAT O.D P.S.C

Practice address

2127 Edsel LN NW
Corydon, IN 47112-2030

Phone

(812) 738-1707

Fax

(812) 738-9054

NPI assigned

Jan 19, 2012

Organization subpart

No

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

Authorized official

Name

Jamie Mattingly

Title

Office Manager

Phone

(812) 738-1707

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1699046896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 EDSEL LN NW",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122030",
            "telephone_number": "812-738-1707",
            "fax_number": "812-738-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 EDSEL LN NW",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122030",
            "telephone_number": "812-738-1707",
            "fax_number": "812-738-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE S. DIDAT O.D P.S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "MATTINGLY",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "812-738-1707"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002547A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100116680B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jewish Hospital & St. Mary's Healthcare, Inc. (Frazier Rehab Institute - Corydon)
• JLD Dental
• Michael A. Jobe, RPH
• David A Johnson, NP
• Derek Richard Jordan, D.C.
• Natalie Katt, OD
• Linda Kaufer
• Autumn L Kaylor
• Jennifer Lynn Kellems, OD
• Paul D Kelty, MD

• Optometrist in Corydon, IN
• Providers in Corydon, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.