NPIMap

Organization Active NPI

Longe Optical

  • Eyewear Supplier
  • Fort Wayne, IN
National Provider Identifier
1770667917
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
LONGE OPTICAL
Practice address
7625 Southtown Crossing
Fort Wayne, IN 46816-2506
Phone
(260) 447-3583
Fax
(260) 441-8276
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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

Authorized official

Name
Mr. Larry Kensill
Title
Owner
Phone
(260) 484-2691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

7625 Southtown Crossing
Fort Wayne, IN 46816-2506

Mailing address

7625 Southtown Crossing
Fort Wayne, IN 46816-2506
Phone (260) 447-3583

Other identifiers 1

IdentifierTypeStateIssuer
100173460BMedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1770667917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 SOUTHTOWN CROSSING",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468162506",
            "telephone_number": "260-447-3583",
            "fax_number": "260-441-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 SOUTHTOWN CROSSING",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468162506",
            "telephone_number": "260-447-3583",
            "fax_number": "260-441-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2009-04-22",
        "status": "A",
        "authorized_official_last_name": "KENSILL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-484-2691",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100173460B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.