Individual provider Active NPI

Karisa Bowman, O.D.

  • Optometrist
  • Lafayette, IN
National Provider Identifier
1811340730
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003987A Issued in IN
Practice address
1221 S Creasy LN Ste a
Lafayette, IN 47905-7430
Phone
(765) 447-4951
Fax
(765) 447-4834
NPI assigned
Jul 15, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003987A IN Primary

Addresses

Primary practice location

1221 S Creasy LN Ste a
Lafayette, IN 47905-7430

Mailing address

1221 S Creasy LN Ste a
Lafayette, IN 47905-7430
Phone (765) 447-4951

Other names 1

  • Karisa Burkholder Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161107000698 IN Practitioner - Optometry 1254619620 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norman Eyecare LTDGroup PAC ID 3173685088, 19 clinicians

Practice addresses (Care Compare)

1410 Union St
Lafayette, IN 47904-2060
Phone (765) 447-5413

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18003987AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Eyecare LTD. Optometrist CurrentSince Nov 18, 2024 Accepting new patients
Norman Eyecare LTD. Optometrist CurrentSince Nov 18, 2024 Accepting new patients
Norman Eyecare LTD. Optometrist Current Accepting new patients
Evans Eye Care Inc Optometrist CurrentSince Jun 1, 2017 Accepting new patients

Locations

1221 S Creasy Ln
Ste A
Lafayette, IN 47905
Phone (765) 447-4951

1410 Union St
Lafayette, IN 47904
Phone (765) 423-2977

3526 Osborne Ln
Lafayette, IN 47909
Phone (765) 447-4951

Interoperability endpoints

  • Direct secure messaging: karisa.bowman@direct.revolutionehr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811340730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S CREASY LN STE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479057430",
            "telephone_number": "765-447-4951",
            "fax_number": "765-447-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S CREASY LN STE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479057430",
            "telephone_number": "765-447-4951",
            "fax_number": "765-447-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "KARISA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003987A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISA",
            "last_name": "BURKHOLDER",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.