NPIMap

Organization Active NPI

20/20 Eye Physicians of Indiana, PC

  • Eyewear Supplier
  • Indianapolis, IN
National Provider Identifier
1780789909
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
0003928578 Issued in IN
Legal business name
20/20 EYE PHYSICIANS OF INDIANA, PC
Practice address
4880 Century Plaza Rd
Suite 140
Indianapolis, IN 46254-5469
Phone
(317) 328-0901
Fax
(317) 328-5038
NPI assigned
Sep 13, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
20/20 EYE PHYSICIANS OF INDIANA, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Donna M Ireland, COA
Title
Practice Manager
Phone
(317) 871-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 0003928578 IN Primary

Addresses

Primary practice location

4880 Century Plaza Rd
Suite 140
Indianapolis, IN 46254-5469

Mailing address

2020 W 86TH St
Suite 200
Indianapolis, IN 46260-1969
Phone (317) 871-5900

Other identifiers 1

IdentifierTypeStateIssuer
CB2286OtherINRAILROAD MEDICARE

Other names 1

  • 20/20 Physicians Optical Other name

National Provider Directory

National Provider Directory
Tax ID family
2020 Eye Physicians of Indiana PC2 organizations share this tax ID, including this one
Part of
2020 Eye Physicians of Indiana PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2020 W 86th St
Ste 200
Indianapolis, IN 46260
Phone (317) 871-5900

Practitioners & affiliated clinicians

Practitioners 3

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": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1780789909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W 86TH ST",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601969",
            "telephone_number": "317-871-5900",
            "fax_number": "317-872-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 CENTURY PLAZA RD",
            "address_2": "SUITE 140",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545469",
            "telephone_number": "317-328-0901",
            "fax_number": "317-328-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20/20 EYE PHYSICIANS OF INDIANA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "20/20 EYE PHYSICIANS OF INDIANA, PC",
        "enumeration_date": "2006-09-13",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "IRELAND",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "317-871-5900",
        "authorized_official_credential": "COA"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IN",
            "license": "0003928578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB2286",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "20/20 Physicians Optical",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "20/20 Physicians Optical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.