Susan M. Whitehead O.D. Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002844 Issued in IN

Legal business name

SUSAN M. WHITEHEAD O.D. INC

Practice address

400 W Northfield Dr
Brownsburg, IN 46112-8122

Phone

(317) 858-3083

Fax

(317) 858-8403

NPI assigned

Sep 12, 2008

Last updated

Sep 12, 2008By 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. Susan Maureen Poe, O.D.NPI 1104922079

Title

President

Phone

(317) 459-0398

Specialties & licenses 1

Addresses

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.

• Susan Maureen Poe, O.D.

  • Optometrist
  • Brownsburg, IN
  • NPI 1104922079
  NPD (past) Authorized official

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1790934982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W NORTHFIELD DR",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461128122",
            "telephone_number": "317-858-3083",
            "fax_number": "317-858-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W NORTHFIELD DR",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461128122",
            "telephone_number": "317-858-3083",
            "fax_number": "317-858-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN M. WHITEHEAD O.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-12",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "POE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MAUREEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-459-0398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; 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.