NPIMap

Organization Active NPI

Doctors Park Eyecare LLC

  • Ophthalmology Physician
  • Columbus, IN
National Provider Identifier
1730523119
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01030454 Issued in IN
Legal business name
DOCTORS PARK EYECARE LLC
Practice address
1930 Doctors Park Dr
Columbus, IN 47203-2219
Phone
(812) 372-4463
Fax
(812) 372-2802
NPI assigned
Apr 29, 2013
Last updated
Apr 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Dr. Max A Henry, MDNPI 1295755841
Title
Owner/Medical Doctor
Phone
(812) 372-4463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 01030454 IN Primary

Addresses

Primary practice location

1930 Doctors Park Dr
Columbus, IN 47203-2219

Mailing address

1930 Doctors Park Dr
Columbus, IN 47203-2219
Phone (812) 372-4463

Other identifiers 4

IdentifierTypeStateIssuer
1730523119OtherGROUP NPI
200823550MedicaidIN
1295755841OtherNPI
000000826911OtherANTHEM

Other names 1

  • MAX A HENRY MD Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1730523119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 DOCTORS PARK DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472032219",
            "telephone_number": "812-372-4463",
            "fax_number": "812-372-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 DOCTORS PARK DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472032219",
            "telephone_number": "812-372-4463",
            "fax_number": "812-372-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS PARK EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "MAX",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MEDICAL DOCTOR",
        "authorized_official_telephone_number": "812-372-4463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01030454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1730523119",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200823550",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1295755841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000826911",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAX A HENRY MD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Columbus, IN

Sources for this page

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