John C Siegltiz

Primary specialty

OptometristTaxonomy code 152W00000X

License

18001358A Issued in IN

Legal business name

JOHN C SIEGLTIZ

Practice address

121 W Main St
Vevay, IN 47043-1125

Phone

(812) 427-2717

Fax

(812) 427-3265

NPI assigned

Oct 30, 2009

Last updated

Oct 30, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John C Siegltiz, O.D.

Title

Owner

Phone

(812) 427-2717

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1780910497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "city": "VEVAY",
            "state": "IN",
            "postal_code": "470430096",
            "telephone_number": "812-427-2717",
            "fax_number": "812-427-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W MAIN ST",
            "city": "VEVAY",
            "state": "IN",
            "postal_code": "470431125",
            "telephone_number": "812-427-2717",
            "fax_number": "812-427-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C SIEGLTIZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "SIEGLTIZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-427-2717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003584A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001358A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200336980A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200950880A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy L. Gray, MPT
• Kelli A Hertz, M.D.
• Hook-Superx LLC (CVS Pharmacy #06813)
• Karen Hopkins
• Jefferson & Craig Township Volunteer Fire Department, Incorporated
• Steven E Konkle
• Keri A Kuppler, PT
• Robin Lynn Lawson, COTA
• Lisle Family Eye Care Inc (Eye Care Group)
• Angelica Marcos, PTA

• Optometrist in Vevay, IN
• Providers in Vevay, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.