Fort Wayne Family Eyecare PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

FORT WAYNE FAMILY EYECARE PC

Practice address

9426 Lima Rd
Suite C
Fort Wayne, IN 46818-8934

Phone

(260) 489-5544

NPI assigned

Jul 8, 2006

Last updated

Mar 24, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Ingle, O.D.

Title

President

Phone

(260) 744-2273

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395619200000",
    "number": "1730112228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9426 LIMA RD",
            "address_2": "SUITE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468188934",
            "telephone_number": "260-489-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9426 LIMA RD",
            "address_2": "SUITE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468188934",
            "telephone_number": "260-489-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE FAMILY EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2014-03-24",
        "status": "A",
        "authorized_official_last_name": "INGLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-744-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100277170B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM NONPAR",
            "identifier": "000000234540",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Wayne Endocrinology PC
• Fort Wayne Endodontics
• Fort Wayne Endoscopy Center LLC
• Fort Wayne Family Dentistry Inc
• Fort Wayne Family Eyecare
• Fort Wayne Fire Department
• Fort Wayne Gi Pathology Services, PC, Inc.
• Fort Wayne Hearing Center & Audiology, Inc. (Quality House Hearing Care Center)
• Fort Wayne Integrative Medicine
• Fort Wayne Medical Clinic PC

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.