Organization Active NPI

Manchester Eyecare LLC

  • Optometrist
  • North Manchester, IN
National Provider Identifier
1780241547
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MANCHESTER EYECARE LLC
Practice address
901 State Road 114 W
North Manchester, IN 46962-1967
Phone
(260) 306-3937
Fax
(260) 982-1822
NPI assigned
May 28, 2019
Last updated
Feb 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Authorized official

Name
Darren MinnichNPI 1043292048
Title
Owner
Phone
(260) 982-8798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

901 State Road 114 W
North Manchester, IN 46962-1967

Mailing address

1752 E Market St
Nappanee, IN 46550-9216
Phone (574) 773-4341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190624002920 IN Part B Supplier - Clinic/Group Practice 8628302742 Receives reassigned benefits from 7 practitioners
Practice locations: North Manchester, IN

National Provider Directory

National Provider Directory

Locations

901 State Road 114 W
North Manchester, IN 46962
Phone (260) 306-3937

Practitioners & affiliated clinicians

Practitioners 8

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": "1559001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1780241547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 E MARKET ST",
            "city": "NAPPANEE",
            "state": "IN",
            "postal_code": "465509216",
            "telephone_number": "574-773-4341",
            "fax_number": "574-773-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 STATE ROAD 114 W",
            "city": "NORTH MANCHESTER",
            "state": "IN",
            "postal_code": "469621967",
            "telephone_number": "260-306-3937",
            "fax_number": "260-982-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-28",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "MINNICH",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-982-8798"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Manchester, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.