DRS. Roush & Will Optometrists Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

DRS. ROUSH & WILL OPTOMETRISTS INC

Practice address

815 Trail Ridge Rd
Albion, IN 46701-1534

Phone

(260) 636-7788

Fax

(260) 636-3463

NPI assigned

Jan 30, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Robert Alan Roush, O.D.NPI 1003811860

Title

President

Phone

(260) 347-3458

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• DRS. Roush & Will Optometrists Inc

  • Optometrist
  • Kendallville, IN
  • NPI 1578613295

  9830165026

  Same PAC ID
• DRS. Roush & Will Optometrists, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Kendallville, IN
  • NPI 1275656209

  9830165026

  Same PAC ID

Locations

Practitioners 6

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

• Robert Alan Roush, O.D.

  • Optometrist
  • Kendallville, IN
  • NPI 1003811860
  Care Compare group NPD Authorized official
• Craig A. Bonham, O.D.

  • Optometrist
  • Fort Wayne, IN
  • NPI 1578525341
  Care Compare group NPD
• Craig Michael Lichlyter, O.D.

  • Optometrist
  • Kendallville, IN
  • NPI 1720392020
  Care Compare group NPD
• Elizabeth Jane Roush, O.D.

  • Optometrist
  • Kendallville, IN
  • NPI 1336451640
  Care Compare group NPD
• Matthew S Will, O.D.

  • Optometrist
  • Kendallville, IN
  • NPI 1710982475
  Care Compare group NPD
• Richard Schuyler Roush, OD

  • Optometrist
  • Louisville, KY
  • NPI 1023225075
  NPD (past)

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1730451279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W RUSH ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551739",
            "telephone_number": "260-347-3458",
            "fax_number": "260-347-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 TRAIL RIDGE RD",
            "city": "ALBION",
            "state": "IN",
            "postal_code": "467011534",
            "telephone_number": "260-636-7788",
            "fax_number": "260-636-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. ROUSH & WILL OPTOMETRISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "ROUSH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-347-3458",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100355140B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "967880",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100355140A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100355140C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle L. Creech, MSW
• Kenneth L Cripe, D.C.
• Haley Criswell, LCSW
• Gabrielle Cutino, MSW
• Daviess County Hospital
• Rebecca Dundon, MSED
• Michael R. Engle, D.O.
• Sage Evans
• Fischer Pharmacare, LLC
• Kedisha Ruchel Gardener, FNP

• All providers in Albion, IN
• Eyewear Supplier in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.